UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000029992
Receipt number R000033754
Scientific Title The evaluation of the best diagnostic strategy to rule out non-ST elevation myocardial infarction in emergency rooms.
Date of disclosure of the study information 2017/12/01
Last modified on 2023/05/21 09:32:07

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Basic information

Public title

The evaluation of the best diagnostic strategy to rule out non-ST elevation myocardial infarction in emergency rooms.

Acronym

The evaluation of the diagnostic strategy to rule-out myocardial infarction

Scientific Title

The evaluation of the best diagnostic strategy to rule out non-ST elevation myocardial infarction in emergency rooms.

Scientific Title:Acronym

The evaluation of the diagnostic strategy to rule-out myocardial infarction

Region

Japan


Condition

Condition

myocardial infarction

Classification by specialty

Cardiology Emergency medicine

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

We evaluate the diagnostic accuracy of non-structured models; which is comprised of risk estimation
of history and physical findings in a non-structured way; ECG; troponin; for the composite outcome of myocardial infarction and death within 30 days. Model 1 uses troponin value on arrival. Model 2 uses troponin values on arrival and after 1 hour. Model 3
uses troponin values on arrival and after 2 hours.

Basic objectives2

Others

Basic objectives -Others

We compare the diagnostic accuracy of non-structured models and structured models (existing prediction rules).

Trial characteristics_1

Exploratory

Trial characteristics_2

Explanatory

Developmental phase

Not applicable


Assessment

Primary outcomes

The primary outcomes are the diagnostic accuracy of three non-structured models for composite of myocardial infarction and death within 30 days. The measures of accuracy are; negative predictive value; sensitivity; percentages of patients eligible for rule-out of myocardial infarction. The non-structured models are comprised of three elements and judged as positive if at least one of the elements is positive. 3 non-structured models are below.
*Model 1
1: history and physical findings are high risk
2: presence of new ischemic changes of ECG
3: troponin on arrival is positive
*Model2
1: history and physical findings are high risk
2: presence of new ischemic changes of ECG
3: troponin on arrival and/or after one hour is
positive
*Model 3
1: history and physical findings are high risk
2: presence of new ischemic changes of ECG
3: troponin on arrival and/or after 2 hours is
positive

Key secondary outcomes

*Secondary outcome 1
Comparison of the diagnostic accuracy of non-structured models and structured models
*Secondary outcome 2
We separate patients by some factors, such as onset to arrival time; presence or absence of chest pain; past history of myocardial infarction; past history
of coronary artery disease.
*Secondary outcome 3
Reliabilities of the risk estimation of history and physical findings in a non-structured way; each component of history and physical findings; ECG.


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

25 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

1) Age: =>25 year old
2) Symptoms suggesting myocardial infarction
1. chest pain
2. non-chest pain
A. radiation pain
B. syncope
C. dyspnea
D. nausea
E. fatigue
F. symptoms which emergency physician judges
to rule out myocardial infarction
3) Symptom onset is within 6 hours
4) No ST elevation at presentation
5) Emergency physician judges to take both ECG
and troponin to rule out myocardial infarction

Key exclusion criteria

Satisfies any of the below
1) Cardiopulmonary arrest on arrival
2) Non-cardiac terminal illness
3) Shock status
4) Indication of immediate coronary angiography
5) Inability to obtain informed consent
6) History of severe trauma
7) Past registration for this study
8) Inability of telephone follow up
9) Unknown onset time
10) Judged as inappropriate by a board certified
emergency physician
11) Respiratory failure
12) Apparent need to admit for a diagnosis other than ACS
13) Patients on maintenance dialysis

Target sample size

1500


Research contact person

Name of lead principal investigator

1st name
Middle name
Last name Masafumi Tada

Organization

Kyoto university graduate school of medicine

Division name

Department of health promotion and human behavior

Zip code


Address

Konoe-cho, Sakyo-ku, Kyoto

TEL

075-753-9491

Email

tada.masafumi.76r@st.kyoto-u.ac.jp


Public contact

Name of contact person

1st name
Middle name
Last name Masafumi Tada

Organization

Kyoto university graduate school of medicine

Division name

Department of health promotion and human behavior

Zip code


Address

Konoe-cho, Sakyo-ku, Kyoto

TEL

075-753-9491

Homepage URL


Email

tada.masafumi.76r@st.kyoto-u.ac.jp


Sponsor or person

Institute

Kyoto university

Institute

Department

Personal name



Funding Source

Organization

Nakatani foundation

Organization

Division

Category of Funding Organization

Non profit foundation

Nationality of Funding Organization



Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization


Address


Tel


Email



Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2017 Year 12 Month 01 Day


Related information

URL releasing protocol

https://bmjopen.bmj.com/content/9/9/e026985.abstract

Publication of results

Unpublished


Result

URL related to results and publications


Number of participants that the trial has enrolled


Results


Results date posted


Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics


Participant flow


Adverse events


Outcome measures


Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2018 Year 05 Month 01 Day

Date of IRB

2018 Year 02 Month 27 Day

Anticipated trial start date

2018 Year 07 Month 01 Day

Last follow-up date

2023 Year 03 Month 31 Day

Date of closure to data entry

2023 Year 03 Month 31 Day

Date trial data considered complete

2023 Year 03 Month 31 Day

Date analysis concluded



Other

Other related information

unpublished


Management information

Registered date

2017 Year 11 Month 15 Day

Last modified on

2023 Year 05 Month 21 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000033754


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name