Quality of Care in AS IMPULSE Study

NCT ID: NCT02241447

Last Updated: 2020-03-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

2173 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-08-08

Study Completion Date

2018-05-31

Brief Summary

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The purpose of this study is to narrow the gap between patients being diagnosed with severe aortic stenosis and those being appropriately monitored and treated. For this purpose a prospective survey of current practice (3 months) will be conducted followed by a six month period of intervention during which a variety of quality improvements measures will be implemented. There will then be a 3 month follow-up period during which the legacy of this initiative will be monitored during which no intervention will be carried out.

Detailed Description

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All patients meeting pre-specified criteria (severe aortic stenosis whether with or without symptoms) will be collected. There will be three phases at each site observation A, intervention, observation B. Observation A: In this phase, the nurse identifies cases with severe AS and collects their data. Baseline data for each patient will be collected and a follow-up will be done after three months for each patient to determine his/her outcome and the treatment that was decided on. There will also be an optional telephone follow-up to find out the patient's outcome.

Intervention: In this phase, the physician referring a patient for echocardiography will be notified of a finding of severe aortic stenosis: the nurse brings cases with severe AS to the attention of the referring physician within a week (via phone, e-mail or letter) to make them aware of the diagnosis.

Baseline and follow-up data will be collected for each patient as before. Moreover, more detailed data with regard to the patient's health status will be documented.

Observation B: Same as Observation Phase A

Conditions

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Aortic Valve Stenosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Observation

the nurse identifies cases with severe AS and collects their data. Baseline data for each patient will be collected and a follow-up will be done after three months for each patient to determine his/her outcome and the treatment that was decided on

No interventions assigned to this group

Early information

in this arm, the physician referring a patient for echocardiography will be notified of a finding of severe aortic stenosis: the nurse brings cases with severe AS to the attention of the referring physician within a week (via phone, e-mail or letter) to make them aware of the diagnosis.

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Aortic valve area \< 1cm2
* Indexed aortic valve area \<0.6 cm/m2
* Maximum Jet velocity \> 4.0 m/sec
* Mean transvalvular gradient \> 40 mmHg

Exclusion Criteria

* Non-severe aortic Stenosis (AS)
* Previous aortic valve replacement (AVR)
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Edwards Lifesciences

INDUSTRY

Sponsor Role collaborator

Institut für Pharmakologie und Präventive Medizin

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Richard Steeds, MD

Role: PRINCIPAL_INVESTIGATOR

Queen Elizabeth Hospital, Birmingham, UK

Norbert Frey, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Cardiology and Angiology, University of Kiel, Germany

Davia Messika-Zeitoun, MD

Role: PRINCIPAL_INVESTIGATOR

Hôpital Bichat, Paris FR

Locations

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Krankenhaus Hietzing

Vienna, , Austria

Site Status

IKEM - Institute for Clinical and Experimental Medicine

Prague, , Czechia

Site Status

Centre Hospitalier d'Annecy

Annecy, , France

Site Status

Bichat Hospital

Paris, , France

Site Status

Charité - Campus Benjamin Franklin

Berlin, , Germany

Site Status

Herzzentrum Universitätsklinikum Köln

Cologne, , Germany

Site Status

Universitätsklinikum Erlangen

Erlangen, , Germany

Site Status

Westpfalz Klinikum

Kaiserslautern, , Germany

Site Status

UKSK Campus Kiel, Klinik für Kardiologie und Angiologie

Kiel, , Germany

Site Status

Universitätsmedizin der Johannes Gutenberg-Universität Mainz

Mainz, , Germany

Site Status

Städtisches Klinikum München

München, , Germany

Site Status

Krankenhaus der Barmherzigen Brüder

Trier, , Germany

Site Status

Università degli Studi di Bari Aldo Moro

Bari, , Italy

Site Status

University "Magna Græcia" of Catanzaro

Catanzaro, , Italy

Site Status

IRCCS San Matteo Hospital

Pavia, , Italy

Site Status

Policlinico Umberto I Rom

Rome, , Italy

Site Status

University of Torino

Torino, , Italy

Site Status

AMC Medical Center

Amsterdam, , Netherlands

Site Status

Santa Creu Barcelona

Barcelona, , Spain

Site Status

UniversitätsSpital Zürich

Zurich, , Switzerland

Site Status

Queen Elizabeth Hospital

Birmingham, , United Kingdom

Site Status

Bart Heart Center

London, , United Kingdom

Site Status

James Cook University Hospital

Middlesbrough, , United Kingdom

Site Status

Countries

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Austria Czechia France Germany Italy Netherlands Spain Switzerland United Kingdom

References

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Steeds RP, Lutz M, Thambyrajah J, Serra A, Schulz E, Maly J, Aiello M, Rudolph TK, Lloyd G, Bortone AS, Hauptmann KE, Clerici A, Delle-Karth G, Rieber J, Indolfi C, Mancone M, Belle L, Lauten A, Arnold M, Bouma BJ, Deutsch C, Kurucova J, Thoenes M, Bramlage P, Frey N, Messika-Zeitoun D. Facilitated Data Relay and Effects on Treatment of Severe Aortic Stenosis in Europe. J Am Heart Assoc. 2019 Oct;8(19):e013160. doi: 10.1161/JAHA.119.013160. Epub 2019 Sep 24.

Reference Type DERIVED
PMID: 31549578 (View on PubMed)

Frey N, Steeds RP, Rudolph TK, Thambyrajah J, Serra A, Schulz E, Maly J, Aiello M, Lloyd G, Bortone AS, Hauptmann KE, Clerici A, Delle Karth G, Rieber J, Indorfi C, Mancone M, Belle L, Lauten A, Arnold M, Bouma BJ, Lutz M, Pohlmann C, Kurucova J, Thoenes M, Bramlage P, Messika-Zeitoun D; IMPULSE registry group. Symptoms, disease severity and treatment of adults with a new diagnosis of severe aortic stenosis. Heart. 2019 Nov;105(22):1709-1716. doi: 10.1136/heartjnl-2019-314940. Epub 2019 Jul 13.

Reference Type DERIVED
PMID: 31302639 (View on PubMed)

Related Links

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Other Identifiers

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IMPULSE

Identifier Type: -

Identifier Source: org_study_id

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