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CompletedNCT04864795CARE-HKUpdated Nov 4, 2024

Cardiovascular and Renal Treatment in Heart Failure Patients With Hyperkalaemia or at High Risk of Hyperkalaemia

An observational study in Heart Failure and Hyperkalemia, sponsored by Vifor (International) Inc.. Completed at 116 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-11-04.

Sponsored by Vifor (International) Inc. · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
2,636
Ages
18 Years and older
Sex
All
01

Study summary

The CARE-HK in HF is a registry study based on the hypothesis that adherence to guidelines is associated with improved real-world outcomes for heart failure (HF) patients. For the purpose of this study, adherence to guidelines is defined as adherence to RAASi treatment recommendations, according to the AHA/ACC and ESC guidelines. Objectives relating to patiromer effectiveness will only be evaluated if a sufficient number of patients are available.

The study aims to evaluate in patients at high risk of hyperkalaemia; patients treated with ACEi/ARB/ARNi, and either treated with or candidates for treatment with MRA.

Read the detailed description

The study will have an enrolment period of approximately 24 months, and each patient will be followed prospectively for at least 6 months. Each patient is expected to contribute to the study data collection until study end or until premature discontinuation, whichever occurs first (i.e., due to death, withdrawal of consent, or lost to follow-up).

At enrolment (informed consent signed by patient), relevant patient data will be retrospectively extracted from medical records for the 24 months prior to enrolment or since the time of HF diagnosis.

There are no visits or procedures associated with the study, patients will follow routine clinical care, which may include in-person and/or virtual visits. The study protocol does not recommend the use of any specific treatments and no study medication is provided as part of participation. The nature and heterogeneity of HF means patients will be treated with different treatments over the course of the study, and at the discretion of their treating physician.

Patient data will be collected from patient records and/or during a routine clinical visit and will be entered into the electronic Case Report Form (eCRF) via an electronic data capture (EDC) system. This will include treatments prescribed, routine assessments and measurements (e.g., laboratory parameters) collected at routine clinical visits, as well as hospitalisations and other relevant patient data. Protocol version 3.0, 19-Jul-2023

02

Conditions studied

  • Heart Failure
  • Hyperkalemia
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

To the extent possible, representative sites (e.g., cardiologists and nephrologists) reflective of the treatment patterns within each country will be recruited. All patients treated for chronic HF during the enrolment period will be assessed for eligibility, and all eligible patients will be consecutively proposed to enrol in the study as they present for a routine clinical visit (in-person or virtual visits) in order to avoid potential selection bias.

Inclusion criteria

  1. Adult aged ≥18 years at enrolment.
  2. Patient diagnosed with chronic HF ≥3 months prior to signature of informed consent.
  3. Patient has at least 1 record of LVEF documented in patient medical record in the 24 months prior to signature of informed consent. NOTE: If the proportion of patients with HFpEF exceeds 20% of the target sample size, enrolment of patients with an LVEF ≥50% may be capped.
  4. Patient treated with ACEi/ARB/ARNi at enrolment.
  5. Patient treated with or a candidate for treatment with MRA per a relevant treatment guideline (e.g., HF, CKD, resistant hypertension) at enrolment.
  6. Patient at increased risk of hyperkalaemia due to one or more of the following:

    1. Current hyperkalaemia (sK+ >5.0 mEq/l) at enrolment
    2. Record of documented hyperkalaemia (sK+ >5.0 mEq/l) in the 24 months prior to signature of informed consent
    3. eGFR \<45 ml/min/1.73 m2, or CKD Stage ≥3b.
  7. Patient judged by the Investigator to have sufficient cognitive ability to participate.
  8. Signed informed consent provided

Exclusion criteria

Exclusion Criteria:

  1. Patient on renal replacement therapy or mechanical circulatory support.
  2. Disease other than HF with expected survival \<1 year.
  3. Patient is participating in, or being screened for, an interventional trial, with the exception of interventional trials relating to SARS-CoV-2.
  4. Patient already found to be intolerant to MRA for reasons other than hyperkalaemia or renal impairment.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
2,636 participants (actual)
Target follow-up
6 Months
Patient registry
Yes

Groups and cohorts

  • Single Cohort

    Patient data will be collected from patient records and/or during a routine clinical visit. This will include treatments prescribed, routine assessments and measurements collected at routine clinical visits, as well as hospitalisations and other relevant patient data.

05

What researchers measure

Primary outcomes

  1. Percentage of patients by RAASi optimisation

    overall

    Time frame: at 6-months intervals

  2. Percentage of patients by RAASi dose modification following hyperkalaemic episodes

    RAASi

    Time frame: at 6-month intervals after a hyperkalaemic episode

  3. Comparison of percentage of patients with RAASi treatment optimisation between patiromer treated and untreated patients following hyperkalaemic

    episodes

    Time frame: at 6-months following enrolment

Secondary outcomes

  1. Occurrence and incidence of hyperkalaemia events by RAASi treatment optimisation

    RAASi

    Time frame: at 6-months following enrolment

  2. Description of physician provided reasons for treatment decisions at initiation or modification/discontinuation of RAASi treatment

    RAASi

    Time frame: up to 6 months following enrolment

  3. Description and change of disease status measured by patient reported outcome (PRO) by RAASi treatment optimisation

    Kansas City Cardiomyopathy Questionnaire (KCCQ)

    Time frame: at enrolment and at approximately 6-months intervals

06

Study locations

116 sites
  • University of Arkansas for Medical Sciences
    Little Rock, Arkansas 72205, United States
  • UC San Diego Sulpizio Cardiovascular Center
    La Jolla, California 92037, United States
  • Amicis Research Center
    Northridge, California 91324, United States
  • Bridgeport Hospital
    Bridgeport, Connecticut 06610, United States
  • Bethesda Hospital East
    Boynton Beach, Florida 33425, United States
  • Clearwater Cardiovascular Consultants
    Clearwater, Florida 33756, United States
  • Innovative Research of West Florida, Inc.
    Clearwater, Florida 33756, United States
  • Inpatient Research Clinic, LLC
    Hialeah, Florida 33013, United States
  • Clearwater Cardiovascular Consultants
    Largo, Florida 33777, United States
  • D&H National Research Centers
    Miami, Florida 33173, United States
  • Southwest Florida Research, LLC
    Naples, Florida 34102-8143, United States
  • Peace River Cardiovascular Center
    Port Charlotte, Florida 33952, United States
  • Clearwater Cardiovascular and Interventional Consultants
    Safety Harbor, Florida 32695, United States
  • Florida Cardiology P.A
    Winter Park, Florida 32792, United States
  • IACT Health
    Columbus, Georgia 31904, United States
  • Cardiology Care Clinics
    Eatonton, Georgia 31024, United States
  • NSC Research
    Johns Creek, Georgia 30024, United States
  • Chicago Medical Research, LLC
    Hazel Crest, Illinois 60429-2196, United States
  • Prairie Cardiovascular Consultants, Ltd.
    Springfield, Illinois 62701, United States
  • Cardiovascular Medicine, P.C.
    Davenport, Iowa 52803, United States
  • Central Cardiology Associates
    Elizabethtown, Kentucky 42701, United States
  • Maine Health
    Biddeford, Maine 04005, United States
  • Johns Hopkins University
    Baltimore, Maryland 21218, United States
  • TidalHealth Peninsula Regional Inc.
    Salisbury, Maryland 21801, United States
  • Ascension St. Mary's Hospital
    Saginaw, Michigan 48601, United States
  • Minneapolis Heart Institute Foundation
    Minneapolis, Minnesota 55407, United States
  • St. Louis Heart and Vascular
    Bridgeton, Missouri 63044, United States
  • Saint Luke's Hospital of Kansas City
    Kansas City, Missouri 64111, United States
  • St. Louis University
    Saint Louis, Missouri 63104, United States
  • Logan Health Research
    Kalispell, Montana 59901, United States
  • Virtua Medical Group PA
    Marlton, New Jersey 08053-4197, United States
  • Raritan Bay Primary and Cardiology Associates
    Matawan, New Jersey 07747, United States
  • The Heart House
    Sewell, New Jersey 08080, United States
  • Albany Stratton VA Medical Center
    Albany, New York 12208, United States
  • Capital Cardiology Associates
    Albany, New York 12211, United States
  • South Shore University Hospital
    Bay Shore, New York 11706, United States
  • Focus Clinical Research Solutions
    Charlotte, North Carolina 28204, United States
  • Nephrology Associates of Greater Cincinnati
    Cincinnati, Ohio 45236, United States
  • Rama Research LLC
    Marion, Ohio 43302, United States
  • The Heart and Medical Center
    Durant, Oklahoma 74701, United States
  • Capital Area Research, LLC
    Camp Hill, Pennsylvania 17011, United States
  • UPMC Presbyterian Hospital
    Pittsburgh, Pennsylvania 15213, United States
  • UT Southwestern Medical Center
    Dallas, Texas 75390, United States
  • East Texas Cardiology PA
    Houston, Texas 77002, United States
  • Biopharma Informatic, LLC
    Houston, Texas 77084, United States
  • Texas Cardiology Associates of Houston
    Kingwood, Texas 77339, United States
  • Complete Heart Care
    McKinney, Texas 75071, United States
  • Baylor Scott & White Round Rock
    Round Rock, Texas 78665, United States
  • Baylor Scott & White Health - Temple
    Temple, Texas 76508, United States
  • Victoria Heart & Vascular Center
    Victoria, Texas 77901, United States
  • Richmond Cardiology Associates
    Mechanicsville, Virginia 23116, United States
  • William S. Middleton Memorial VA Hospital
    Madison, Wisconsin 53705, United States
  • KH St. Josef Braunau
    Braunau Am Inn, Austria
  • LKH Universitatklinikum Graz
    Graz, Austria
  • Ordensklinkum Linz Elisabethinen
    Linz, Austria
  • Allgemeines Krankenhaus der Stadt Wien
    Wien, Austria
  • Imed-19 privat
    Wien, Austria
  • Klinik Floridsdorf
    Wien, Austria
  • Cliniques Universitaires de Bruxelles Hopital Erasme
    Brussels, Belgium
  • Cliniques Universitaires Saint-Luc
    Bruxelles, Belgium
  • Grand Hôpital de Charleroi
    Charleroi, Belgium
  • AZ Sint-Blasius
    Dendermonde, Belgium
  • CHU de Liège
    Liège, Belgium
  • AZ Glorieux
    Ronse, Belgium
  • Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi IRCCS
    Bologna, Italy
  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (Presidio Spedali Civili)
    Brescia, Italy
  • Azienda Ospedaliera Universitaria Arcispedale Sant'Anna
    Ferrara, Italy
  • Azienda Ospedaliero Universitaria Ospedali Riuniti di Foggia
    Foggia, Italy
  • A.O.U. Policlinico di Modena
    Modena, Italy
  • Centro Cardiologico Monzino-IRCCS
    Monza, Italy
  • Azienda Ospedaliera Universitaria "Federico II"
    Napoli, Italy
  • Azienda Ospedaliero Universitaria Pisana
    Pisa, Italy
  • Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia
    Reggio Emilia, Italy
  • IRCCS San Raffaele Pisana
    Roma, Italy
  • IRCCS Ospedale Policlinico San Martino
    San Martino, Italy
  • Azienda Servizi Sanitari 1 Triestina
    Triest, Italy
  • Hospital Universitario Central de Asturias
    Oviedo, Asturias 33011, Spain
  • Hospital Universitario Severo Ochoa
    Leganés, Madrid, Spain
  • Hospital Universitario Puerta de Hierro Majadahonda
    Majadahonda, Madrid, Spain
  • Complejo Hospitalario de Navarra
    Pamplona, Navarra, Spain
  • Hospital Universitari Germans Trias i Pujol
    Badalona, Spain
  • Hospital clinic de Barcelona
    Barcelona, Spain
  • Hospital de la Santa Creu i Sant Pau
    Barcelona, Spain
  • Hospital Universitari de Bellvitge
    Barcelona, Spain
  • Hospital Universitari Vall d'Hebron
    Barcelona, Spain
  • Hospital Universitario Virgen de las Nieves
    Granada, Spain
  • Juan Ramon Jimenez Hospital
    Huelva, Spain
  • Complejo Hospitalario de Jaen
    Jaén, Spain
  • Complejo Hospitalario Universitario A Coruña
    La Coruña, Spain
  • Hospital Universitario de Gran Canaria Dr. Negrin
    Las Palmas De Gran Canaria, Spain
  • Hospital Universitario Clinico San Carlos
    Madrid, Spain
  • Hospital Universitario Infanta Leonor
    Madrid, Spain
  • Hospital Universitario La Paz
    Madrid, Spain
  • Hospital Universitario Ramon y Cajal
    Madrid, Spain
  • Hospital Clinico Universitario Virgen de la Victoria
    Málaga, Spain
  • Hospital Universitario Puerto Real
    Puerto Real, Spain
  • Hospital Universitario Virgen del Rocío
    Sevilla, Spain
  • Hospital Universitario Virgen Macarena
    Sevilla, Spain
  • Hosp. Universitari Sant Joan de Reus
    Tarragona, Spain
  • Kantonsspital Aarau AG
    Aarau, Switzerland

Showing the first 100 of 116 sites across 7 countries.

07

References and documents

Individual participant data

Plan to share: Yes — Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.

Supporting information: Study protocol, Sap

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT04864795
Lead sponsor
Vifor (International) Inc.
Responsible party
Sponsor
First posted
Apr 29, 2021
Start date
Apr 19, 2021
Primary completion
Feb 29, 2024
Completion
Aug 30, 2024
Last update
Nov 4, 2024

Study contacts

Sandra Wächter
study chair · Vifor International

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
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