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Trial registered on ANZCTR
Registration number
ACTRN12624000389505
Ethics application status
Approved
Date submitted
25/01/2024
Date registered
3/04/2024
Date last updated
3/04/2024
Date data sharing statement initially provided
3/04/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Stepping towards precision rehabilitation; Establishing potential benefits and safety of early cardiac rehabilitation in diabetics post acute coronary syndrome
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Scientific title
Stepping towards precision rehabilitation; Establishing potential benefits and safety of early cardiac rehabilitation in diabetics post acute coronary syndrome.
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Secondary ID [1]
311411
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Nil known
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Universal Trial Number (UTN)
U1111-1303-2967
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Coronary Syndrome
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Condition category
Condition code
Cardiovascular
329402
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0
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Coronary heart disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Immediate enrolment in cardiac rehab (12 weeks exercise-based program, Cardihab educational support, telehealth follow-up) 1-week post revascularization of acute myocardial infarction.
- Accredited exercise physiologist will be supervising the exercise session.
- Patient will attend individually or in group no more than 6.
- Exercise prescription will be personalized based on the cardiopulmonary exercise testing and therefore will incorporate various level of exercise intensity (low, moderate and in some participants vigorous). Two supervised exercise sessions per week (each consisting of 30 minutes of aerobic training and 30 minutes of resistance training), one unsupervised 30–60 minute home-based aerobic exercise session per week. Each exercise program is individually prescribed based on the baseline maximal exercise test and regular submaximal incremental exercise tests performed throughout the intervention. This periodization plan follows a modified version of the 2:1 step paradigm (2 weeks of loading, 1 week unloading).
- Educational session will be facilitating by a clinical research nurse through the CardiHab Platform (https://cardihab.com/). Standard educational materials will be used and selected based on intake history in order to optimize secondary prevention strategies, including diet, nutrition, and lifestyle factor modification. These are standard education materials from the CardiHab (TGA registered) platform, designed to meet TGA guidelines for secondary prevention of cardiac disease.
- Telehealth follow up will be conducted by a research assistant and escalated to the clinical research nurse and or PI/Cardiology when appropriate. It will serve as a check-in, data collection, and advice provided as required.
- follow up with occur 12 months following enrollment.
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Intervention code [1]
327849
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Rehabilitation
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Comparator / control treatment
Standard of care - cardiac rehab. All interventions the same but intervention/rehab timeline as per standard care. The control group will receive the same program but at a delayed time. It usually takes 1-2 months to enrol in cardiac rehabilitation depending on the program, our study's comparator is specific enrolment one week after having an acute cardiac event versus the usual enrolment process (which is variable between programs, usually depending on demand).
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Control group
Active
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Outcomes
Primary outcome [1]
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Proportion of participants who experience functional improvement at 6 months determined by change in exercise capacity
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Assessment method [1]
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Cardiopulmonary exercise test (CPET) using stationary cycle and a standardized ramp test protocol and activity monitoring using accelerometer (ARTG actigraph).
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Timepoint [1]
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Baseline and 6 months post-randomization.
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Secondary outcome [1]
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Change in self-reported quality of life metrics
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Assessment method [1]
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HRQOL metrics via self-reported questionnaire via telehealth. Kansas City Cardiomyopathy Questionnaire, SF-36 questionnaire, (all questionnaires relate to quality-of-life self-assessment). This will be assessed as a composite outcome as a combination of each questionnaire.
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Timepoint [1]
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Baseline, 3 months and 12 months post-randomization.
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Secondary outcome [2]
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Cardiovascular mortality
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Assessment method [2]
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Exercise will be performed using a cardiopulmonary exercise test on a treadmill.
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Timepoint [2]
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Baseline and 6 months post-randomization.
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Secondary outcome [3]
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Metabolic parameters
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Assessment method [3]
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HbA1c, fasting glucose, total cholesterol on blood test
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Timepoint [3]
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Baseline and 6 months post-randomization.
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Secondary outcome [4]
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Visual analogue score assessing quality of life
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Assessment method [4]
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Visual analogue scale with questions designed specifically for this study
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Timepoint [4]
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Baseline and 6 months post-randomization
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Eligibility
Key inclusion criteria
1. 18-80 years
2. Fluent in English
3. Fulfills Universal definition for Type I myocardial infarction within 2 weeks of enrolment
4. Diagnosed with Type II Diabetes
5. Ability to perform a bout of exercise on a treadmill or bike
6. Access to the Internet and Smart phone
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Minimum age
18
Years
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Maximum age
80
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. > 80 years of age
2. Stage V Chronic Kidney Disease
3. Liver disease with documented cirrhosis
4. Severe pulmonary disease (FEV < 50%)
4. Type I Diabetes
5. History of sustained ventricular tachycardia with haemodynamic collapse or aborted sudden cardiac death.
6. Pregnancy
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomization by computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomization stratified by sex (male or female), with a 1:1 allocation via a computer-generated random number generator.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/04/2024
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Actual
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Date of last participant enrolment
Anticipated
27/01/2025
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Actual
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Date of last data collection
Anticipated
26/01/2026
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Actual
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Sample size
Target
70
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
315673
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Charities/Societies/Foundations
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Name [1]
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National Heart Foundation of Australia
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Other Collaborative groups
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Name
Baker Heart and Diabetes Institute
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Address
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Country
Australia
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Secondary sponsor category [1]
317776
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None
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Name [1]
317776
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Address [1]
317776
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Country [1]
317776
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314551
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
314551
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Australia
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Date submitted for ethics approval [1]
314551
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24/08/2023
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Approval date [1]
314551
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17/10/2023
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Ethics approval number [1]
314551
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Summary
Brief summary
Cardiovascular disease is the leading cause of death and disability among adults globally. In Australia it is the lead contributor to health care expenditure and with an ageing population the burden of disease is expected to increase. Cardiac rehab is an effective secondary prevention tool post acute coronary syndrome acute coronary syndrome but is underutilised and inconsistently delivered. The trial will whether early cardiac rehabilitation in high-risk acute coronary syndrome results in greater functional improvement at 6 months when compared to later and standard of care, examine the safety of cardiopulmonary testing to support exercise prescription, and define the metabolic profiles of post acute coronary syndrome.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Kegan Moneghetti
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+61 03 8532 1866
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Eloise Thompson
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+61 03 8532 1862
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Eloise Thompson
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Address
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Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne VIC 3004
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Country
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Australia
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Phone
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+61 03 8532 1862
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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