BROKEN-SWEDEHEART- Optimized Pharmacological Treatment for Broken Heart (Takotsubo) Syndrome.

NCT ID: NCT04666454

Last Updated: 2024-12-02

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

1000 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-14

Study Completion Date

2028-12-31

Brief Summary

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The aim of this study is to document an optimized pharmacologic treatment for patients with Takotsubo Syndrome. There is currently no published documentation in a large number of patients. The study is a Randomized Registry Clinical Trial and in total 1000 patients registered in SWEDEHEART will be included.

Detailed Description

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Conditions

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Takotsubo Syndrome

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Multinational, Multicentre, registry-based, open-label, randomized controlled trial with 2 × 2 factorial design
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Randomisation 1: Adenosine and Dipyridamole

Adenosine infusion 70 µg/kg/min for 3 hours, followed (first dose 60 minutes apart from the end of the adenosine infusion) by daily oral treatment with the adenosine reuptake inhibitor dipyridamole (200 mg b.i.d.) until normalization of Left Ventricular (LV) function (EF≥50%) is documented on the study-specific echocardiographic assessment at 48-96 hours or at any subsequent echocardiographic examination, or for 30+7 Days.

Group Type ACTIVE_COMPARATOR

Adenosine

Intervention Type DRUG

Adenosine infusion 70 µg/kg/min for 3 hours.

Dipyridamole 200 mg

Intervention Type DRUG

200 mg b.i.d

Randomisation 1: Control

Care as recommended by the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology.

Group Type OTHER

Care as recommended by the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology for takotsubo syndrome

Intervention Type OTHER

This treatment will vary depending on local routines and the degree of adherence to the recommendations.

Randomisation 2: Apixaban

Apixaban 5mg b.i.d. per oral until normalization of LV function (EF≥50%) is documented on the study-specific echocardiographic assessment at 48-96 hours or any subsequent echocardiographic examination, or for 30+7 Days.

Group Type ACTIVE_COMPARATOR

Apixaban 5 mg Oral Tablet

Intervention Type DRUG

5mg b.i.d

Randomisation 2: No anticoagulant therapy

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Adenosine

Adenosine infusion 70 µg/kg/min for 3 hours.

Intervention Type DRUG

Dipyridamole 200 mg

200 mg b.i.d

Intervention Type DRUG

Apixaban 5 mg Oral Tablet

5mg b.i.d

Intervention Type DRUG

Care as recommended by the Taskforce on Takotsubo Syndrome of the Heart Failure Association of the European Society of Cardiology for takotsubo syndrome

This treatment will vary depending on local routines and the degree of adherence to the recommendations.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years.
2. A clinical diagnosis of TS (see definition 2.1), including an ejection fraction (EF) ˂ 50 % at baseline
3. Written informed consent obtained

Exclusion Criteria

1. Previous randomization in the trial
2. Any concomitant condition resulting in a life expectancy of less than one month
3. Previously diagnosed left ventricular ejection fraction \<50%
4. Known cardiomyopathy (except previous Takotsubo syndrome)
5. Known hemodynamically significant valve disease (moderate or severe aortic/mitral regurgitation) or stenosis
6. Heart transplant or left ventricular assist device recipient
7. Most recent (within the most recent 3 months) haemoglobin ˂10 g/dL
8. Systolic blood pressure \<80 mm Hg at screening
9. Estimated glomerular filtration rate \<30 mL/min/1.73m2
10. Current dialysis
11. Pregnancy or of childbearing potential who is not sterilized or is not using a medically accepted form of contraception
12. Not suitable in the opinion of the investigator due to severe or terminal comorbidity with poor prognosis, or characteristics that may interfere with adherence to the trial protocol

13. Any contra-indication for treatment with adenosine or dipyridamole (including AV-block II and III, sick-sinus syndrome in subjects who don´t have a functioning pacemaker, unstable angina, ongoing treatment with dipyridamole)
14. Severe asthma (defined as asthma requiring medium or high-dose inhaled corticosteroids combined with other long-acting medications) and severe Chronic Obstructive Pulmonary Disease (COPD), (defined as FEV-1 ˂ 50 %)
15. Ongoing treatment with dipyridamole
16. Declined participation in study 1


1. Any contra-indication for anticoagulant treatment.
2. Current indication for treatment with, anticoagulant or dual antiplatelet therapy
3. Declined participation in study 2
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Göteborg University

OTHER

Sponsor Role collaborator

Vastra Gotaland Region

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elmir Omerovic, MD PhD

Role: PRINCIPAL_INVESTIGATOR

Sahlgrenska University Hospital

Locations

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Aarhus Universitetshospital

Aarhus, , Denmark

Site Status RECRUITING

Rigshospitalet

Copenhagen, , Denmark

Site Status RECRUITING

Oslo University Hospital

Oslo, , Norway

Site Status RECRUITING

Östersund Sjukhus

Östersund, Jämtland Härjedalen, Sweden

Site Status RECRUITING

Region Jönköpings Län

Jönköping, Region Jönköping, Sweden

Site Status RECRUITING

Norra Älvsborgs länssjukhus

Trollhättan, Västra Götalands Region, Sweden

Site Status RECRUITING

Region Dalarna

Falun, , Sweden

Site Status RECRUITING

Sahlgrenska University Hospital, Department of Cardiology

Gothenburg, , Sweden

Site Status RECRUITING

Skaraborg Hospital

Gothenburg, , Sweden

Site Status RECRUITING

Region Skane Helsingborg Hospital

Helsingborg, , Sweden

Site Status RECRUITING

Region Oestergoetland

Linköping, , Sweden

Site Status RECRUITING

Region Skane - Skanes Universitetssjukhus

Lund, , Sweden

Site Status RECRUITING

Region Orebro lan

Örebro, , Sweden

Site Status RECRUITING

Danderyds Hospital, Department of Cardiology

Stockholm, , Sweden

Site Status RECRUITING

Karolinska University Hospital, Huddinge, Department of Cardiology

Stockholm, , Sweden

Site Status RECRUITING

Umeå University Hospital, Department of Cardiology

Umeå, , Sweden

Site Status RECRUITING

Countries

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Denmark Norway Sweden

Central Contacts

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Elmir Omerovic, MD PhD

Role: CONTACT

31 3421000 ext. +46

Björn Redfors, MD, PhD

Role: CONTACT

31 3421000 ext. +46

Facility Contacts

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Steen Hvitfeldt Poulsen, MD

Role: primary

Lia Evi Bang, MD

Role: primary

Njord Nordstrand, MD

Role: primary

Fredrik Björklund, MD

Role: primary

063-14 75 00

Dario Gulin, MD

Role: primary

010-241 00 00

Imran Tahir, MD

Role: primary

010-435 00 00

Per Lundberg, MD

Role: primary

Lisa Brandin, MD

Role: primary

Sven-Erik Olsson, MD

Role: primary

Joakim Alfredsson, MD

Role: primary

Nazim Isma, MD

Role: primary

Anna Nordenskjöld, MD

Role: primary

Christina Ekenbäck, MD

Role: primary

Loghman Henareh, MD

Role: primary

Henrik Hagström, MD

Role: primary

References

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Omerovic E, James S, Erlinge D, Hagstrom H, Venetsanos D, Henareh L, Ekenback C, Alfredsson J, Hambreus K, Redfors B. Rationale and design of BROKEN-SWEDEHEART: a registry-based, randomized, parallel, open-label multicenter trial to test pharmacological treatments for broken heart (takotsubo) syndrome. Am Heart J. 2023 Mar;257:33-40. doi: 10.1016/j.ahj.2022.11.010. Epub 2022 Nov 23.

Reference Type DERIVED
PMID: 36435233 (View on PubMed)

Other Identifiers

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BROKEN SWEDEHEART

Identifier Type: -

Identifier Source: org_study_id