- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00680706
Thiamine and Acute Decompensated Heart Failure: Pilot Study
Targeting Myocardial Energy Metabolism for the Treatment of Acute Heart Failure: The Effect of Thiamine on Biochemical, Electrocardiographic and Respiratory Parameters in Hospitalized Patients.
Heart failure remains an increasing cause of morbidity and mortality in the United States even in the face of recent advances in the treatment of cardiovascular disease. There is an urgent need to reevaluate the treatment of heart failure. Shifting substrate utilization used in energy metabolism from fatty acids to glucose is beneficial to the heart presumably by increasing the efficiency of ATP production. Several new drugs for the treatment of cardiac ischemia work by this mechanism. There is increasing evidence that patients with heart failure may also benefit by the same type of intervention. Patients with heart failure are known to have low serum thiamine levels because of poor dietary intake and increased urinary excretion. Inadequate thiamine will deleteriously shift substrate utilization from glucose to fatty acids.
We hypothesize that thiamine supplementation will be beneficial for patients with heart failure by increasing glucose and decreasing fatty acid utilization. This will be initially tested in a pilot double-blinded placebo controlled study of thiamine supplementation in diabetic and non-diabetic patients presenting to the emergency department with acute decompensated heart failure.
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02215
- Beth Israel Deaconess Medical Center
-
Springfield, Massachusetts, United States, 01199
- Baystate Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- History of heart failure on a loop diuretic.
- Worsening dyspnea over the past 24 hours.
- Currently dyspneic sitting or supine, on or off oxygen.
- Radiographic cephalization of vessels. This criteria is not needed if the patient has no other reason for being dyspneic after being evaluated in the emergency department.
- Elevated NT pro-BNP (>450).
- Able to communicate in English or Spanish.
- Able and willing to provide informed consent.
- Age > 18 years.
- A primary admitting diagnosis of acute decompensated heart failure.
Exclusion Criteria:
- Renal failure on dialysis.
- Severe valvular disease.
- EKG criteria for acute myocardial infarction (ST segment elevation > 1mm on two contiguous leads).
- Initial troponin elevated.
- Ventricular arrhythmia (ventricular tachycardia or fibrillation).
- Supraventricular arrhythmia (atrial fibrillation / flutter) with a ventricular rate >120 beats per minute.
- Taking a daily thiamine supplementation (any multivitamin or specific thiamine supplementation within the past 2 weeks. Fortified foods, such as cereals, are acceptable
- Taking a daily fatty acid supplement.
- Pregnancy as determined by standard serum or urine b-HCG assay.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Control
|
D5W (50 ml)
|
Experimental: Thiamine
Receives thiamine
|
Thiamine (100 mg) in 50 ml D5W, x 2.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Effect of Thiamine Supplementation on Dyspnea
Time Frame: Baseline
|
Sitting Upright on Oxygen.
Measured using a 10-centimeter visual analog scale (VAS).
Measures are in units of millimeters (mm).
A smaller number should be interpreted as a less dyspnea.
A larger number should be interpreted as a more dyspnea.
Less dyspnea is a better clinical outcome than more dyspnea.
|
Baseline
|
Effect of Thiamine Supplementation on Dyspnea
Time Frame: 8-Hour
|
Sitting Upright on Oxygen.
Measured using a 10-centimeter visual analog scale (VAS).
Measures are in units of millimeters (mm).
A smaller number should be interpreted as a less dyspnea.
A larger number should be interpreted as a more dyspnea.
Less dyspnea is a better clinical outcome than more dyspnea.
|
8-Hour
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Howard Smithline, MD, Baystate Medical Center
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 07-059
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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-
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