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REGISTRY EVALUATION OF VITAL INFORMATION FOR VADs IN AMBULATORY LIFE (REVIVAL)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT01369407
Recruitment Status : Completed
First Posted : June 8, 2011
Last Update Posted : September 7, 2018
Sponsor:
Collaborators:
National Heart, Lung, and Blood Institute (NHLBI)
Brigham and Women's Hospital
Information provided by (Responsible Party):
Keith Aaronson, University of Michigan

Tracking Information
First Submitted Date June 1, 2011
First Posted Date June 8, 2011
Last Update Posted Date September 7, 2018
Actual Study Start Date July 2015
Actual Primary Completion Date August 29, 2018   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures
 (submitted: July 15, 2015)
  • To characterize clinical outcomes, quality of life and functional impairment over two (2) years in a population of ambulatory patients on evidence-based therapy with advanced chronic systolic heart failure who may benefit from VAD therapy [ Time Frame: 2 years ]
  • To evaluate the relationship between heart failure subject's modeled prognosis, self assessed prognosis, preferences for end of life care and thresholds for considering VAD implant. [ Time Frame: 2 years ]
  • To evaluate caregiver burden associated with heart failure subject's measures of heart failure severity, quality of life, functional limitations and with preferences for care and thresholds for considering device implant. [ Time Frame: 2 years. ]
  • To determine health-associated costs for heart failure subjects in the registry. [ Time Frame: 2 years. ]
  • To provide the REVIVE-IT Registry to the INTERMACS study group to be used in comparative analyses of outcomes of patients treated with medical versus VAD therapy. [ Time Frame: 2 years. ]
Original Primary Outcome Measures
 (submitted: June 7, 2011)
Composite outcome [ Time Frame: 2 years ]
  1. Survival
  2. Freedom from major disabling stroke (defined as Modified Rankin Scale (MRS) > 4)
  3. Improvement of 6 Minute Walk Test distance by >75 meters from pre-randomization baseline
Change History
Current Secondary Outcome Measures
 (submitted: July 15, 2015)
  • Hospitalization [ Time Frame: 2 years ]
    Assessed throughout participation
  • Stroke [ Time Frame: 2 years ]
    Assessed throughout participation
  • MCSD [ Time Frame: 2 years ]
    Assessed throughout participation (study endpoint)
  • Transplant [ Time Frame: 2 years ]
    Assessed throughout participation (study endpoint)
  • Death [ Time Frame: 2 years ]
    Assessed throughout participation
Original Secondary Outcome Measures
 (submitted: June 7, 2011)
  • Primary composite outcome [ Time Frame: 1 year ]
    1. Survival
    2. Freedom from major disabling stroke (defined as Modified Rankin Scale (MRS) > 4)
    3. Improvement of 6 Minute Walk Test distance by >75 meters from pre-randomization baseline
  • Functional capacity [ Time Frame: 2 years ]
    Assessed by: 6 Minute Walk test, peak oxygen consumption, % predicted V02, lean body mass adjusted peak Vo2, VE/VCO2 slope, anaerobic threshold, NYHA functional class
  • Health-related Quality of Life and Health Utility [ Time Frame: 2 years ]
    Assessed by completion of various instruments
  • Neurocognition [ Time Frame: 2 years ]
  • Heart failure-related adverse events [ Time Frame: 2 years ]
    Worsening heart failure resulting in non-elective hospitalization, emergency department visit, urgent clinic visit at which intravenous therapy is administered.
  • Hospital Readmission [ Time Frame: 2 years ]
  • Cost and cost-effectiveness [ Time Frame: 2 years ]
  • LVAD associated adverse events (as defined by INTERMACS) [ Time Frame: 2 years ]
  • Cross-over rates to LVAD in the OMM arm [ Time Frame: 2 years ]
  • Cross-over rates to cardiac transplantation in the OMM and LVAD arms [ Time Frame: 2 years ]
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title REGISTRY EVALUATION OF VITAL INFORMATION FOR VADs IN AMBULATORY LIFE
Official Title REVIVE-IT Registry (REVIVAL: Registry Evaluation of Vital Information For VADs in Ambulatory Life)
Brief Summary REVIVAL will establish a prospective, observational, multicenter patient cohort in ambulatory patients with chronic, advanced, systolic heart failure that will provide a greater understanding of their clinical trajectory (rates of hospitalizations, transplantation, MCSD use and death), and of how baseline clinical risk measures are related to prognosis.
Detailed Description

REVIVAL will establish a prospective, observational, multicenter patient cohort in ambulatory patients with chronic, advanced, systolic heart failure that will provide a greater understanding of their clinical trajectory (rates of hospitalizations, transplantation, MCSD use and death), and of how baseline clinical risk measures are related to prognosis. Within the broader goal of 1) improving prognostic assessment in chronic, ambulatory, advanced systolic heart failure, additional targeted goals are to 2) better inform the selection of appropriate candidates for a future study of a strategy of early LVAD therapy vs. optimal medical management in this population, and 3) determine the feasibility of identifying candidates for such a trial. Therefore, the target population will have known high-risk features for increased mortality and hospitalization (e.g., frequent hospitalization, reduced exercise capacity, elevated BNP or N-terminal proBNP, increased Seattle Heart Failure Model risk score, reduced Heart Failure Survival Score).

The REVIVE-IT Registry (i.e., REVIVAL) is a prospective cohort study to be conducted in up to twenty five (25) participating Clinical Sites in the USA. The study will continue until up to 400 eligible heart failure heart failure subjects have been enrolled (estimated length of accrual is 12 months).

Study Type Observational [Patient Registry]
Study Design Observational Model: Cohort
Time Perspective: Prospective
Target Follow-Up Duration 2 Years
Biospecimen Retention:   Samples With DNA
Description:
Biomarker Samples will be collected at the Baseline B assessment. Samples for Genomic Analysis will be collected at the Baseline B visit for subjects that consented to collection of this sample type.
Sampling Method Non-Probability Sample
Study Population Medical records should be reviewed to assess for potential enrollment into the REVIVE-IT Registry. Heart failure subjects that meet all criteria should be approached to consent for this study.
Condition Congestive Heart Failure
Intervention Other: No Intervention
Not an interventional study
Study Groups/Cohorts Enrolled Subjects
Enrolled subjects participate for up to 2 years
Intervention: Other: No Intervention
Publications *

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status Completed
Actual Enrollment
 (submitted: July 15, 2015)
400
Original Estimated Enrollment
 (submitted: June 7, 2011)
100
Actual Study Completion Date August 29, 2018
Actual Primary Completion Date August 29, 2018   (Final data collection date for primary outcome measure)
Eligibility Criteria

Inclusion Criteria:

  1. Ambulatory.
  2. Chronic systolic heart failure ≥ 12 months.
  3. NYHA II - IV for at least 45 of the last 60 days.
  4. Last documented left ventricular ejection fraction ≤ 35% by any imaging modality.
  5. Age 18 - 80 years.
  6. Under the care of a cardiologist at study site.
  7. On appropriate evidenced -based heart failure medications - ACE inhibitor, ARB or sacubitril/valsartan [LCZ-696]; beta blocker; aldosterone antagonist; hydralazine/long-acting nitrate [required of African-American subjects only] for ≥ 3 months absent contraindications or intolerances.
  8. Has ICD or CRT-D. If CRT-D, present for ≥ 3 months.
  9. Demonstrated advanced heart failure, including any one of the following*:

    i. Serum sodium ≤ 135 mEq/L (obtained as an outpatient)** ii. Serum BNP ≥ 750 pg/mL or NT-proBNP ≥ 3000 pg/mL** (obtained as an outpatient) iii. Seattle Heart Failure Model (SHFM) one year predicted survival ≤ 85%** iv. Heart Failure Survival Score (HFSS) ≤ 7.19** v. Peak VO2 ≤ 55% of predicted for age by Wasserman equation or ≤ 14 ml/kg/min, with RER ≥ 1.05*** vi. VE/VC02 slope > 40*** vii. 6 minute walk test (6MWT) distance ≤ 350 m without significant non-cardiac limitation** viii. Currently listed as Heart Transplant Status II due to heart failure limitation

    Or

    History of one (1) hospitalization (≥ 24 hours) for acute or acute on chronic heart failure in the past year with additional history to include:

    i. Serum BNP ≥ 500 pg/mL or NT-proBNP ≥ 2000 pg/mL** (obtained as an outpatient)

    Or

    History of two (2) hospitalizations (≥ 24 hours) for acute or acute on chronic heart failure in the past year.

    * Qualifying measure must be the most recent of that type of measure obtained (i.e., a BNP ≥ 1000 obtained 2 months prior would not qualify the heart failure subject if a more recent BNP was < 1000)

    **Using values obtained within the prior 90 days, except for peak VO2 within 365 days

    ***Obtained within the prior 365 days

  10. Willingness to continue to receive heart failure care from the enrolling advanced heart failure clinic over the next two (2) years and to come for all scheduled study visits.

12. Written Informed consent given.

Exclusion Criteria:

  1. Known serious medical problem other than heart failure that would be expected to limit 2-year survival (≥50% mortality within 2 years from non-heart failure diagnosis).
  2. Patient is not likely to be compliant with the protocol, in the opinion of the Investigator.
  3. Currently hospitalized.
  4. Current use of an intravenous inotrope.
  5. Primary functional limitation from non-cardiac diagnosis even if not likely to limit survival.
  6. Chronic hemodialysis or peritoneal dialysis or a serum creatinine value of ≥ 3 mg/dL at time of enrollment.
  7. Cardiac amyloidosis, cardiac sarcoidosis, constrictive pericardial disease, active myocarditis or congenital heart disease with significant structural abnormality.
  8. Hypertrophic cardiomyopathy unless dilated LV and no outflow gradient.
  9. Cardiac conditions that are amenable to surgical or percutaneous procedures (other than VAD or transplant) that would substantially improve prognosis and for which this subject is a reasonable candidate, regardless of whether the procedure will or will not be performed.
  10. Uncorrected hyperthyroidism or hypothyroidism.
  11. Pregnancy.
Sex/Gender
Sexes Eligible for Study: All
Ages 18 Years to 80 Years   (Adult, Older Adult)
Accepts Healthy Volunteers No
Contacts Contact information is only displayed when the study is recruiting subjects
Listed Location Countries United States
Removed Location Countries  
 
Administrative Information
NCT Number NCT01369407
Other Study ID Numbers REVIVE-IT REGISTRY (REVIVAL)
HHSN268201100026C ( Other Grant/Funding Number: NHLBI )
Has Data Monitoring Committee No
U.S. FDA-regulated Product Not Provided
IPD Sharing Statement Not Provided
Current Responsible Party Keith Aaronson, University of Michigan
Original Responsible Party Francis Pagani, MD, PhD, University of Mighigan
Current Study Sponsor University of Michigan
Original Study Sponsor Same as current
Collaborators
  • National Heart, Lung, and Blood Institute (NHLBI)
  • Brigham and Women's Hospital
Investigators
Principal Investigator: Keith Aaronson, MD, MS University of Michigan
Principal Investigator: Garrick Stewart, MD Brigham and Women's Hospital
Study Chair: Doug Mann, MD University of Washington - St. Louis
PRS Account University of Michigan
Verification Date September 2018