Acute Heart Failure Clinical Trial
Official title:
Multimarker Approach for Acute Dyspnea in Elderly Patients Admitted in the Emergency Department
Elderly people constitute the largest proportion of emergency department (ED) patients,
representing 12% of all ED admissions. The need for diagnostic tests or therapeutic
interventions is much greater in this patient population. Cardiovascular diseases and
symptoms represent 12% of the causes for ED admission, and patients suffering from
cardiovascular disease are those whose ED visit lasts longest.
The diagnostic approach in the ED in elderly patients admitted for acute dypsnoea is complex,
and early identification of acute left-sided heart failure (ALSHF) is vital as it has an
impact on prognosis. The clinical signs are difficult to interpret, and are non-specific,
particularly at the acute phase and in elderly or obese patients. Indeed, some authors have
reported up to 50% of diagnostic errors in elderly patients.
Measure of the blood concentration of a natriuretic peptide allows a quick diagnosis.
However, peptides alone suffer from several limitations, particularly in situations that are
often encountered in elderly patients, such as sepsis, renal failure, acute coronary
syndrome, pulmonary embolism, chronic respiratory failure, atrial fibrillation and high body
mass index. Diagnostic performance deteriorates with increasing age, and there is a
significant increase in this grey-zone in patients aged ≥75 years. In critical situations in
elderly patients, assessment of natriuretic peptides serve mainly to rule out a diagnosis of
left heart failure.
Some authors have studied other biomarkers showing their performance in the diagnosis of
ALSHF. These are biomarkers involved in remodeling and myocardial fibrosis (ST2, Galectin-3)
or involved in myocardial injury (High-sensitivity Troponin-I).
Therefore, a combined "multimarker" approach could improve the diagnostic performance of
ALSHF.
READ (NCT02531542) is a diagnostic study including patients over the age of 75 admitted to
acute dyspnea in the ED, to demonstrate the superiority of an ultrasound protocol (the READ
protocol) on NT-proBNP in the ALSHF diagnosis.
The hypothesis is that the diagnostic accuracy of a multimarker diagnostic approach, namely
the READ-MA method, combining NT-proBNP, High-sensitivity Troponin-I, ST2 and Galectin-3
would be superior to that of NT-proBNP assessment for the diagnosis of ALSHF in elderly
patients (≥75 years) admitted to the ED.
n/a
| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Terminated |
NCT02151383 -
Pharmacokinetics & Safety of Serelaxin on Top of Standard of Care Therapy in Pediatric Patients With Acute Heart Failure
|
Phase 2 | |
| Completed |
NCT02135835 -
A Study to Evaluate the Efficacy and Safety of Shenfu Zhusheye in Patients With Acute Heart Failure
|
Phase 4 | |
| Recruiting |
NCT05556044 -
Empagliflozin for New On-set Heart Failure Study Regardless of Ejection Fraction
|
Phase 3 | |
| Recruiting |
NCT04363697 -
Dapagliflozin and Effect on Cardiovascular Events in Acute Heart Failure -Thrombolysis in Myocardial Infarction 68 (DAPA ACT HF-TIMI 68)
|
Phase 4 | |
| Completed |
NCT02122640 -
Evaluation of Acute Cardiogenic Dyspnoea With Thorax Echography and Pro-BNP in the Emergency Department
|
N/A | |
| Completed |
NCT01193998 -
Impact of Validated Diagnostic Prediction Model of Acute Heart Failure in the Emergency Department
|
N/A | |
| Not yet recruiting |
NCT01211886 -
Utility of Brain Natriuretic Peptide (BNP) in Patients With Type IV Cardio-renal Syndrome Admitted to the Intensive Care Unit (ICU)
|
N/A | |
| Not yet recruiting |
NCT06465498 -
Investigating aCute heArt failuRe Decongestion Guided by Lung UltraSonography
|
N/A | |
| Recruiting |
NCT05276219 -
Optimized Treatment of Pulmonary Edema or Congestion
|
Phase 4 | |
| Recruiting |
NCT05392764 -
Early Treatment With a Sodium-glucose Co-transporter 2 Inhibitor in High-risk Patients With Acute Heart Failure
|
Phase 3 | |
| Recruiting |
NCT03157219 -
Manipal Heart Failure Registry (MHFR)
|
N/A | |
| Completed |
NCT06024889 -
Acute Effects of Furosemide on Hemodynamics and Pulmonary Congestion in Acute Decompensated Heart Failure.
|
Phase 1/Phase 2 | |
| Terminated |
NCT04174794 -
Investigating Reduction of aCute heArt Failure Readmission With Lung UltraSound-preliminary Trial
|
||
| Recruiting |
NCT05972746 -
Telemonitoring Program in the Vulnerable Phase After Hospitalization for Heart Failure
|
N/A | |
| Enrolling by invitation |
NCT02258984 -
Can the Venus 1000 Help Clinicians Treat Patients With Severe Sepsis or Acute Heart Failure? The CVP Trial
|
N/A | |
| Completed |
NCT02141607 -
Evolution of Molecular Biomarkers in Acute Heart Failure Induced by Shock
|
||
| Completed |
NCT01870778 -
Efficacy, Safety and Tolerability of Serelaxin When Added to Standard Therapy in AHF
|
Phase 3 | |
| Recruiting |
NCT05986773 -
Diuretic Strategies in Acute Heart Failure Patients at High Risk for Diuretic Resistance
|
Phase 4 | |
| Recruiting |
NCT04163588 -
Sequential Nephron Blockade in Acute Heart Failure
|
Phase 3 | |
| Recruiting |
NCT03720288 -
Acetazolamide in Patients With Acute Heart Failure
|
Phase 3 |