- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04347330
Cardiovascular Risk Reduction in Atrial Fibrillation Trial (CRAFT)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Xin Du, Doctor
- Phone Number: 86-10-64420102
- Email: duxinheart@sina.com
Study Contact Backup
- Name: Chao Jiang, Doctor
- Phone Number: 86-10-84005361
- Email: superj@zju.edu.cn
Study Locations
-
-
-
Beijing, China
- Recruiting
- Beijing Anzhen Hospital
-
Contact:
- Xin Du, MD, PhD
-
Contact:
- Chao Jiang, MD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Screening and Run-in Assessment
All patients with documented AF (paroxysmal, persistent) and standard office SBP 140-179 mmHg if not on BP-lowering drugs or 125-164 mmHg with BP-lowering drugs, will be screened for inclusion into the run-in assessment phase.
The run-in assessment is for 2 weeks. In the run-in phase, patients should be treated according to guideline recommendation, with combined antihypertension agents. Patients should also be guided to measure and upload HBPM measurements correctly. BP measurements (3 readings in the morning and 3 readings in the evening) are required to be uploaded every day for a week before the end of run-in assessment. Patients with average home SBP 125-154 mmHg during the run-in assessment are considered eligible for study inclusion. If home SBP ≥155 mmHg or <125 mmHg at the time of run-in assessment, another 2 weeks run-in phase can be extended, during which time antihypertensive drugs can be titrated according to the BP lowering algorithm used in this study.
Inclusion Criteria
- Adults, ≥18 years old
- Documented AF: persistent atrial fibrillation or at least two episodes of intermittent atrial fibrillation in the previous 6 months.
- Home SBP 125-154 mmHg, defined as average of all SBP readings (at least 3 readings 1 min apart in the morning before taking antihypertensive drugs and evening before going to sleep) during the run-in assessment.
- One or more cardiovascular risk factors: (1) Prior history of thromboembolism: defined as any of the following criteria: a) ischemic stroke; b) transient ischemic attack (TIA); c) systemic embolism (SE); (2) Diabetes mellitus (DM): defined as any of the following criteria: a) use of oral hypoglycemic drugs or insulin; b) random blood glucose values ≥11.1 mmol/L in the presence of classic symptoms of hyperglycemia; c) fasting plasma glucose values ≥7.0 mmol/L; d) two-hour plasma glucose values ≥11.1 mmol/L during an oral glucose tolerance test; e) HbA1C values ≥6.5%; (3) Coronary artery disease or Peripheral artery disease: defined as any of the following criteria: a) Previous myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), carotid endarterectomy (CE), carotid stenting; b) Peripheral artery disease (PAD) with revascularization; c) Acute coronary syndrome with or without resting ECG change, ECG changes on a graded exercise test, or positive cardiac imaging study; d) At least a 50% diameter stenosis of a coronary, carotid, or lower extremity artery; e) Abdominal aortic aneurysm ≥5 cm with or without repair; (4) Chronic kidney disease (CKD): defined as estimated glomerular filtration rate (eGFR) 30-59ml/min/1.73m2 based on the latest lab value within the past 6 months; (5) Age ≥65 years old
Exclusion Criteria
- Successful AF ablation (no documented recurrence of AF, atrial flutter, or atrial tachycardia lasting >30s)
- Moderate-to-severe mitral stenosis, or mechanical heart valve replacement
- Home SBP ≥145 mmHg while already taking ≥4 full dose BP lowering agents, indicating resistant hypertension or poor adherence.
- Unable to upload home BP readings for at least 5 days during the run-in assessment.
- An indication for a specific BP lowering medication (e.g., beta-blocker following acute myocardial infarction) that the person is not taking, without evidence of intolerance. The screenee should be on the appropriate dose of such medication before assessing whether he/she meets the CRAFT inclusion criteria.
- Known secondary cause of hypertension that causes concern regarding safety of the protocol.
- One minute standing SBP < 110 mm Hg. Not applicable if unable to stand due to wheelchair use.
- Diagnosis of polycystic kidney disease
- Glomerulonephritis treated with or likely to be treated with immunosuppressive therapy
- eGFR <30 mL/min/1.73m2 or end-stage renal disease (ESRD)
- Cardiovascular event or procedure (as defined above as Coronary artery disease or Peripheral artery disease for study entry) or hospitalization for unstable angina within last 3 months
- Heart failure with reduced left ventricular ejection fraction (< 40%), or New York Heart Association Class III-IV
- Individuals who have been previously diagnosed with dementia by their physicians
- A medical condition likely to limit survival to less than 3 years, or a cancer diagnosed and treated within the past two years that, in the judgment of clinical study staff, would compromise a participant's ability to comply with the protocol and complete the trial.
- Any factors judged by the investigator to be likely to limit adherence to interventions. For example, active alcohol or substance abuse, significant memory or behavioural disorder.
- Currently participating in another clinical trial (intervention study). Note: Patient must wait until the completion of his/her activities or the completion of the other trial before being screened for CRAFT.
- Living in the same household as an already randomized CRAFT participant
- Any organ transplant
- Unintentional weight loss > 10% in last 6 months
- Pregnancy, currently trying to become pregnant, or of child-bearing potential and not using birth control
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intensive BP Control
Participants randomized into the Intensive BP Control arm will have a goal of home SBP <120mmHg.
For most participants in the Intensive Group, a two- or three-drug regimen should be initiated at randomization.
Following the randomization visit, addition of another drug or medication dose titration is indicated if home SBP is ≥120 mmHg.
Monthly visits will continue in the Intensive Group until home SBP <120 mmHg or no more titration planned.
If the home SBP is not <120 mmHg at the every 6-month visit, then an antihypertensive drug from a class different from what is being taken should be added, rather than up-titration the dosage of previous drugs, unless there are compelling reasons against this practice.
|
Participants in the Intensive group have a goal of home SBP <120 mm Hg.
The CRAFT BP treatment protocol is flexible in terms of the choice and doses of antihypertensive medications, but there should be preferences among the drug classes, based on CVD outcome trials results and current guidelines.
Use of once-daily antihypertensive agents will be encouraged unless alternative frequency is indicated/necessary.
Combination of different classes of agents are encouraged to achieve the home SBP goal.
Medications will not be provided by the CRAFT study.
Other Names:
|
Active Comparator: Standard BP Control
Participants randomized into the Standard BP Control arm will have a goal of home SBP <135mmHg.
The Standard BP protocol is designed to achieve a home SBP of 130-134 mmHg in as many participants as possible.
Following the randomization visit, medication dose titration or addition of another drug is indicated if home SBP ≥135 mmHg.
Monthly visits will continue in the Standard Group when home SBP ≥155 mmHg.
Down titration (a reduction of the dose or number of antihypertensive drugs) should be carried out if the home SBP is <125 mmHg.
|
Participants in the Standard group has a goal of home SBP <135 mmHg.
The same principle of BP treatment in the Intensive BP arm will be used for the Standard BP arm.
Medications will not be provided by the CRAFT study.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Hierarchical composite cardiovascular outcomes
Time Frame: 5 years
|
a hierarchical composite of cardiovascular death, number of strokes, time to first stroke, number of MI, time to first MI, number of HF, and time to first HF
|
5 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
All-cause mortality
Time Frame: 5 years
|
Time to all deaths.
|
5 years
|
Main secondary renal outcomes
Time Frame: 5 years
|
Time to the first occurrence of chronic kidney disease progression or incident albuminuria.
|
5 years
|
Change of the self-report depression
Time Frame: 5 years
|
Change of the depression (measured by the Patient Health Questionnaire-9) from baseline to the end of the study.
|
5 years
|
Change of the self-report anxiety
Time Frame: 5 years
|
Change of the anxiety (measured by the Zung Self-rating Anxiety Scale) from baseline to the end of the study.
|
5 years
|
Change of the concern of falling
Time Frame: 5 years
|
Change of the concern of falling (measured by the Short Fall Self-Efficacy Scale International) from baseline to the end of the study.
|
5 years
|
Change of the frailty
Time Frame: 5 years
|
Change of the frailty (measured by the 5-item FRAIL scale) from baseline to the end of the study.
|
5 years
|
Main secondary cardiovascular outcomes
Time Frame: 5 years
|
Time to the first occurrence of the components of the primary outcome: cardiovascular Death, stroke, myocardial infarction, hospitalization for heart failure.
|
5 years
|
Change of the health state utility
Time Frame: 5 years
|
Change of the health state utility (measured by the EuroQoL Group 5-Dimension Self-Report questionnaire from baseline to the end of the study.
|
5 years
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Major bleeding
Time Frame: 5 years
|
Time to the first major bleeding (ISTH definition).
|
5 years
|
Peripheral arterial disease
Time Frame: 5 years
|
Time to the first peripheral arterial disease, including systemic embolism, carotid and peripheral revascularization, abdominal aortic aneurysm repair, and other objectively defined PAD events.
|
5 years
|
Coronary revascularization
Time Frame: 5 years
|
Time to the first occurrence of percutaneous coronary intervention or coronary artery bypass grafting
|
5 years
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Craig S Anderson, Doctor, The George Institute for Global Health, China; Heart Health Research Centre
- Principal Investigator: Jianzeng Dong, Doctor, Beijing Anzhen Hospital; The First Affiliated Hospital of Zhengzhou University
- Principal Investigator: Changsheng Ma, Doctor, Beijing Anzhen Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2020-005
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Hypertension
-
National Taiwan University Hospital Hsin-Chu BranchRecruitingHypertension,Essential | Hypertension, MaskedTaiwan
-
BayerCompletedPrimary HypertensionChina
-
University of Alabama at BirminghamTroy UniversityCompletedHypertension | Hypertension, Resistant to Conventional Therapy | Uncontrolled Hypertension | Hypertension, White CoatUnited States
-
Columbia UniversityAgency for Healthcare Research and Quality (AHRQ)Active, not recruitingWhite Coat Hypertension | Hypertension,EssentialUnited States
-
Addpharma Inc.Completed
-
Universidade Federal de Santa MariaCompletedHealthy Volunteers | Hypertension, EssentialBrazil
-
Sheffield Teaching Hospitals NHS Foundation TrustUniversity of SheffieldCompletedIdiopathic Pulmonary Arterial Hypertension | Chronic Thromboembolic Pulmonary HypertensionUnited Kingdom
-
China Academy of Chinese Medical SciencesGuang'anmen Hospital of China Academy of Chinese Medical SciencesCompletedHypertension, Resistant to Conventional Therapy | Primary HypertensionChina
-
Sulaiman AlRajhi CollegesUnknownHypertension, Essential | β-hydroxybutyrate
Clinical Trials on Intensive BP Control
-
Shanghai Institute of HypertensionRecruiting
-
University of MinnesotaMayo Clinic; University of Pennsylvania; University of Alabama at Birmingham; Vanderbilt... and other collaboratorsCompleted
-
National University, SingaporeCompleted
-
Chinese Academy of Medical Sciences, Fuwai HospitalActive, not recruitingPrimary HypertensionChina
-
China National Center for Cardiovascular DiseasesFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen, People's Republic...Not yet recruiting
-
Cedars-Sinai Medical CenterNational Heart, Lung, and Blood Institute (NHLBI); University of Texas Southwestern... and other collaboratorsCompleted
-
China National Center for Cardiovascular DiseasesCompleted
-
Asan Medical CenterPfizerTerminatedBrain IschemiaKorea, Republic of
-
The George Institute for Global Health, ChinaTakeda; Medical Research Council; Department for International Development, United... and other collaboratorsCompletedCardiovascular Diseases | Stroke | Central Nervous System Diseases | Hypertension | Diabetes | Hemorrhage | Intracranial Hemorrhages | Cerebral Hemorrhage | Anticoagulant-induced Bleeding | Cerebral Vascular Disorder | Brain DisorderChina
-
The George Institute for Global Health, ChinaChanghai HospitalTerminatedAcute Ischemic StrokeChina