Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT02252705 |
| Other study ID # |
REMEHIP |
| Secondary ID |
|
| Status |
Completed |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
July 2014 |
| Est. completion date |
April 2018 |
Study information
| Verified date |
June 2023 |
| Source |
Remehip |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational [Patient Registry]
|
Clinical Trial Summary
Prospective multicenter registry including incident patients and prevalent patients which
pretends to identify clinical characteristics, treatment trends in-hospital and four years
follow-up outcome through major adverse cardiovascular events (MACE) in a Mexican population
with well characterized Pulmonary Hypertension.
Description:
Introduction. Pulmonary hypertension (PH) is a worldwide group of vascular diseases
characterized by progressive increase in pulmonary vascular resistance and pulmonary arterial
pressure with secondary vascular and right ventricular (RV) remodeling, RV dysfunction, heart
failure syndromes and, finally, premature death. In developed countries significant medical
advances have occurred in the last two decades including a more systematic assessment and
availability of new therapeutic approaches. In addition, current registries had shown new
data regarding epidemiology, demography, clinical presentation, treatment and prognosis.
However, the evidence coming from developing countries is scarce and more information is
necessary to identify current care in such populations. In the other hand, high quality
clinical registries may help to understand if the knowledge coming from clinical trials is
being properly applied and if their results are reproducible in day-to-day clinical practice.
The results of the REMEHIP, a registry with one-year enrollment and four-year follow-up will
hopefully broad the investigators knowledge about clinical profile, medical care, therapeutic
trends and outcome in a Mexican population with well characterized PH.
Variables to be included. In all patients: a) date of onset of symptoms, b) medical history,
c) personal and family history, c) treatment at enrollment, d) physical examination, d) WHO
function class, e) six-minute walk distance, f) ECG, g) chest x-ray, h) echocardiogram, i)
pulmonary function tests, j) V/Q lung scan and or pulmonary angiography, and/or pulmonary
angiotomography k) right heart catheterization, and whenever possible indicated acute
vasodilator challenge 11, 12, l) biomarkers: troponin I (TnI), brain natriuretic peptide
(BNP), D - dimer (DD), INR, n) current treatment, o) in-hospital and follow - up outcome, p)
MACE.
Visit office. Data will be collected in the first outcome and update through each follow-up
about expected PH symptoms, functional class (WHO), current treatment, dose, compliance,
collateral effects and concomitant medication, weight, blood pressure, heart and respiratory
rate, and biomarkers, when possible or feasible; in patients under oral anticoagulation INR
will be recorded in each visit.
Visits will be according with the standard health care of each center, but in general they
will be made at least one every six months.
Sites. In centers (outcome treatment and tertiary center), investigators with expertise and
experience in diagnosis, stratification and treatment of patients with PH will be involved.
Centers without expertise, but with facilities to diagnosis, stratification (six-minute walk
distance, pulmonary function tests, V/Q lung scan and or pulmonary angiography, right heart
catheterization, and biomarkers) will be included too, as long as they adhere to protocol.
Quality Criteria. Following criteria will be used to improve quality data: a) standardized
definitions, data and reports; b) tools for fast feedback; c) meetings among principal
investigators and steering committee, at least one per year; d) ethics procedures review; e)
electronic, simple and accessible data collection; f) rigorous center selection based on
investigators expertise and/or facilities resources); g) consecutive patients enrollment to
obtain representative sample; h) random centers audit; i) centralized data and statistical
analysis; j) report all data and consistent conclusion; and k) transparency of funds for any
publication. Furthermore, the quality of this registry will also be measured by the number of
publications and presentations in national and international meetings as has previously been
done.
Data collection. Electronic database will have 178 variables including among others, data of
onset symptoms, medical history, personal and family history, physical examination, six -
minute walk distance, treatment, ECG, chest x-ray, echocardiogram, pulmonary function tests,
V/Q lung scan, pulmonary angiography, right heart catheterization, acute vasodilator
challenge, biomarkers and (in the follow - up) MACE.
Statistics. Differences between continuous variables with normal distribution will be
examined by Student's t test. The test of Wilcoxon rank sum will be used when continuous
variables have failed in normality tests. To analyze categorical variables X2 will be used by
Fisher's exact test or Yates correction. A two-tailed test with a p value < 0.05 will be
considered as statistically significant. Logistic regression analysis will be used to select
independent predictors in those variables that by univariate regression analysis had obtained
a p value < 0.01. To avoid confusion, the relationship between historical variables for
atherosclerosis and cardiovascular events will be examined through logistic regression and
multivariate analysis. Cox proportional risk multivariate model will assess the relationship
between each of these variables. Kaplan-Meier survival curves and Cox proportional risk model
will be used for adjust survival analysis. A p value < 0.05 will be considered as
statistically significant. Data will be expressed as percentages, mean, standard deviation,
odds ratio and CI.
