SMASH 1: Scandinavian Multicenter Study to Advance Risk Stratification in Heart Disease- Ventricular Arrhythmias
Study Details
Study Description
Brief Summary
The purpose of this study is to identify markers of increased risk for incident ventricular arrhythmias and cardiovascular events in patients already being treated with an implantable cardioverter-defibrillator (ICD) by exploring patient history and clinical findings, biological markers, ECG markers, and echocardiographic markers.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Detailed Description
This is a multicenter prospective cohort study to assess the prognostic value of potential biomarkers for incident ventricular arrhythmias and cardiovascular events in patients with implantable cardioverter-defibrillator (ICD). In addition to information from the baseline visit and future study visits, the investigators will also register information from the patients medical records concerning comorbidities and previous medical events.
The data will be summarized with respect to demographic and baseline characteristics and risk markers/ measurements. The final diagnosis of incident cardiovascular events will be established by an adjudication committee with two senior physicians reviewing all information available on the patients, including information on the clinical outcome of the patient. The investigators will use multivariate statistical models to assess the individual performance of biomarkers/other tests.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| 1 Derivation cohort (n=474); may be analyzed separately or combined with cohort #2 to enhance statistical power |
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| 2 Validation cohort (patient #475 and after); may be combined with cohort #1 to enhance statistical power |
Outcome Measures
Primary Outcome Measures
- Episodes of ventricular fibrillation (VF) or ventricular tachycardia (VT) resulting in appropriately delivered ICD therapies (including antitachycardia pacing) or sustained ventricular tachyarrhythmia (>100/min, >30sek). [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
Registered from the monitoring function of the ICD
Secondary Outcome Measures
- All-cause mortality [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- Cardiovascular mortality [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- Major adverse cardiac event (MACE), i.e. acute myocardial infarction, stroke, urgent myocardial revascularization and cardiovascular mortality [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- Heart failure hospitalization [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- The combination of cardiovascular mortality and heart failure hospitalizations [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- Number of premature ventricular complexes (PVCs) and non-sustained VT (> 3 coupled PVCs) registered from the monitoring function of the ICD [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- New occurrence of supra-ventricular arrhythmias (i.e. atrial fibrillation, atrial flutter, atrial tachycardia etc.) [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
- Episodes of ventricular- or supra-ventricular arrhythmias (specified above) registered from the monitoring function of the ICD. [Duration of follow-up will be a minimum of 180 days following inclusion of the final patient.]
Eligibility Criteria
Criteria
Inclusion Criteria:
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Patients ≥ 18 years old
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Current treatment with an ICD
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Signed written informed consent before study commencement
Exclusion Criteria:
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Participation in other interventional clinical trial or previously included in the current study
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Patients not able to provide written informed consent
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Known or suspected, non-curable cancer,
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Neurological condition with short life expectancy; e.g. amyotropic lateral sclerosis (ALS)
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Patients unwilling or unable to comply with the protocol
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History of non-compliance to medical management and patients who are considered potentially unreliable by the Investigator
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History or evidence of alcohol or drug abuse with the last 12 months that may influence the participation of the patient in the study, as assessed by the Investigator during the screening phase
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Any surgical or medical condition, which in the option of the Investigator, will impair the ability of the patient to participate in the study
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Akershus University Hospital | Lørenskog | Norway | 1478 |
Sponsors and Collaborators
- University Hospital, Akershus
- Helse Stavanger HF
- University of Oslo
Investigators
- Principal Investigator: Torbjørn Omland, MD,PhD, MPH, Professor of Medicine
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 2015/2080