Cardiovascular Risk Assessment and Dynamic Monitoring-based Prevention Trial

NCT ID: NCT05919056

Last Updated: 2024-11-15

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

NA

Total Enrollment

22032 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-06

Study Completion Date

2028-07-01

Brief Summary

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The CRITICALLY study is a cluster randomized trial that will evaluate the effectiveness of a risk-based dynamic monitoring strategy for the primary prevention of cardiovascular high-risk Chinese adults.

Detailed Description

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The objective of the study is to evaluate the effectiveness of a risk-based management strategy on cardiovascular risk scores (calculated by the 2019 WHO cardiovascular risk charts) in 24 months (Phase I) and the incidence of major adverse cardiovascular events in 60 months (Phase II). Totally 216 clinics in Yinzhou District, China will be randomized to the intervention or the control arms with usual care. The interventions supported by the web-based decision support system include (1) cardiovascular risk assessment, (2) dynamic risk monitoring, and (3) regular visits by the general practitioner every three months. Only usual care will be provided in the control arm. The primary outcome is the change in cardiovascular risk scores for Phase I and the incidence of the composite endpoint of coronary heart disease, stroke, heart failure and all-cause mortality for Phase II. If the comprehensive strategy is proven effective, it could provide evidence for the primary prevention of cardiovascular diseases using digital health technology.

Conditions

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Cardiovascular Diseases

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Intervention arm

The interventions include cardiovascular risk assessment, dynamic risk monitoring, and regular general practitioner (GP) visits. The frequency of risk assessment, risk monitoring, and automatic mobile texting will be once per month, while regular GP visits will be once per three months.

Group Type EXPERIMENTAL

Frequent and automatic cardiovascular risk assessment

Intervention Type OTHER

The 10-year cardiovascular risk scores using the 2019 World Health Organization (WHO) laboratory-based risk charts will be automatically calculated using the latest health information on an EHR-based system per month.

Dynamic risk monitoring

Intervention Type OTHER

High-risk individuals will be reassessed by the Dynamic Risk-based Early wArning and Monitoring (DREAM) system to obtain the short-term risk. The DREAM system will send a text message about advice to the high-risk individual every month. The text message includes information on the health status (e.g., current cardiovascular risk, level of blood pressure and lipid) and real-time warning messages (e.g., high short-term risk).

Regular GP visits

Intervention Type OTHER

The general practitioners will communicate with the participants based on the information automatically generated from the DREAM system every three months: each participant's cardiovascular risk score, health status (e.g., diabetes mellitus and/or hypertension), and Chinese guidelines-based recommendations (e.g., "for the management of dyslipidemia, to provide clear treatment targets for high-risk participants").

Control arm

Current regular management (usual care) will be kept in the control arm. The management objectives are for patients with hypertension or diabetes mellitus. The frequency of follow-up is at least once per three months.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Frequent and automatic cardiovascular risk assessment

The 10-year cardiovascular risk scores using the 2019 World Health Organization (WHO) laboratory-based risk charts will be automatically calculated using the latest health information on an EHR-based system per month.

Intervention Type OTHER

Dynamic risk monitoring

High-risk individuals will be reassessed by the Dynamic Risk-based Early wArning and Monitoring (DREAM) system to obtain the short-term risk. The DREAM system will send a text message about advice to the high-risk individual every month. The text message includes information on the health status (e.g., current cardiovascular risk, level of blood pressure and lipid) and real-time warning messages (e.g., high short-term risk).

Intervention Type OTHER

Regular GP visits

The general practitioners will communicate with the participants based on the information automatically generated from the DREAM system every three months: each participant's cardiovascular risk score, health status (e.g., diabetes mellitus and/or hypertension), and Chinese guidelines-based recommendations (e.g., "for the management of dyslipidemia, to provide clear treatment targets for high-risk participants").

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Residents in the Yinzhou District have a unique health ID;
* Aged 40 to 79 years at the baseline enrollment;
* With high risk of cardiovascular disease evaluated by the 2019 WHO laboratory-based risk models (10-year risk≄10%);

Exclusion Criteria

* Have a history of coronary heart disease, stroke or heart failure;
* Patients with a diagnosis of cancer;
* Refused to provide written informed consent
Minimum Eligible Age

40 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yinzhou District Center for Disease Control and Prevention

UNKNOWN

Sponsor Role collaborator

Peking University

OTHER

Sponsor Role lead

Responsible Party

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Pei Gao

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Xun TANG, PhD, MHS

Role: PRINCIPAL_INVESTIGATOR

Pei GAO, PhD

Role: PRINCIPAL_INVESTIGATOR

Locations

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Yinzhou District Center for Disease Control and Prevention

Ningbo, Zhejiang, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xun TANG, PhD, MHS

Role: CONTACT

+86-10-82801528 ext 317

Facility Contacts

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Peng SHEN, MPH

Role: primary

+86-574-87418718

References

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Lin H, Tang X, Shen P, Zhang D, Wu J, Zhang J, Lu P, Si Y, Gao P. Using big data to improve cardiovascular care and outcomes in China: a protocol for the CHinese Electronic health Records Research in Yinzhou (CHERRY) Study. BMJ Open. 2018 Feb 12;8(2):e019698. doi: 10.1136/bmjopen-2017-019698.

Reference Type BACKGROUND
PMID: 29440217 (View on PubMed)

Liu XF, Li QQ, Chen WY, et al. A dynamic risk-based early warning monitoring system for population-based management of cardiovascular disease. Fundamental Research. 2021:534-542.

Reference Type BACKGROUND

Liu X, Shen P, Zhang D, Sun Y, Chen Y, Liang J, Wu J, Zhang J, Lu P, Lin H, Tang X, Gao P. Evaluation of Atherosclerotic Cardiovascular Risk Prediction Models in China: Results From the CHERRY Study. JACC Asia. 2022 Jan 4;2(1):33-43. doi: 10.1016/j.jacasi.2021.10.007. eCollection 2022 Feb.

Reference Type BACKGROUND
PMID: 36340248 (View on PubMed)

Other Identifiers

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IRB00001052-21060

Identifier Type: -

Identifier Source: org_study_id

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