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Recruiting NCT04552275

The HALT Biomarker Study

Phase I Interventional Aortic Stenosis Hypo-attenuated Leaflet Thickening Bioprosthetic Valve Degeneration

For patients and families

In plain language

An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.

What is being studied
The protocol lists: Proteomics Analysis.
Who it may be relevant to
Registry conditions: Aortic Stenosis, Hypo-attenuated Leaflet Thickening, Bioprosthetic Valve Degeneration. Basic parameters: from 65 years · All.
What needs checking
Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
Where it takes place
United States
Next step
Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Official title

Circulating Biomarkers of Hypo-Attenuated Leaflet Thickening After Transcatheter Aortic Valve Replacement

Overview

The purpose of the HALT Biomarkers study are to identify a panel of circulating proteins that discriminates between patients with and without Hypo-Attenuated Leaflet Thickening (HALT) and can be used to supplement the diagnosis of HALT; to characterize changes in circulating proteins after treatment of HALT with systemic anticoagulation; and to identify circulating proteins that predict the occurrence of HALT. The study population will be adult patients undergoing transfemoral transcatheter aortic valve replacement (TAVR) for severe aortic stenosis (AS) or bioprosthetic valve degeneration. Enrollment will continue until 30 patients with HALT are identified for completion of phase 1. Based on a HALT incidence rate of 10%, we anticipate enrolling 300 patients. Patients are enrolled prior to undergoing transfemoral TAVR. Blood samples, clinical data and echocardiograms will be collected at the following timepoints: baseline (pre-TAVR, T0), post-TAVR (pre-discharge, T1), 30-day follow-up (window 3-9 weeks, T2), and 6-month follow-up (T3). Cardiac 4D CT will be performed at the 30-day follow-up visit to screen for the occurrence of HALT. Patients with HALT will be treated with systemic anticoagulation for 5-6 months, at which point a follow-up CT scan and blood sample will be obtained. Control subjects will also undergo a 6-month study visit with blood sample collection. The study will be conducted within two phases. Phase 1 will serve as a derivation / discovery study in which candidate protein biomarkers of HALT will be identified. Once this is successfully completed, a second cohort will be enrolled within phase 2. Phase 2 will be performed under the auspices a future contract or amendment and will seek to cross-validate the initial study findings.

Interventions

  • Diagnostic test Proteomics Analysis
    Determine a panel of circulating proteins that discriminates between patients with and without Hypo-Attenuated Leaflet Thickening (HALT)

Primary outcome measures

  • Derivation of the panel of circulating proteins indicative of HALT [Time frame: 6 months]
  • Establish the rate at which these characteristics indicative of future HALT [Time frame: 6 months]
Secondary outcome measures (1)
  • Cross-validation of the panel of circulating proteins indicative of HALT [Time frame: 6 months]

Eligibility criteria

Inclusion criteria

  • Age > 65 years
  • Subject with severe native AS or severe bioprosthetic valve degeneration
  • Subject undergoing transfemoral TAVR using a Medtronic Evolut R, Evolut Pro or Evolut Pro+ transcatheter heart valve

Exclusion criteria

  • Chronic anticoagulation therapy
  • Contraindication to systemic oral anticoagulation therapy
  • Chronic kidney disease with EGFR<30 ml/min
  • Bleeding diathesis or known coagulopathy
  • Hypercoagulable state
  • Life-expectancy <12 months due to other medical conditions (e.g., malignancy, severe Alzheimer's disease, etc.)
  • The patient is currently participating in another investigational device or drug study that has not reached its primary objective/endpoint
  • Pregnant, lactating, or planning pregnancy within next 12 months

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation
Non-randomized
Model
Parallel assignment
Masking
Open label
Primary purpose
Diagnostic

Study locations

United States · 3 centers
  • Massachusetts General Hospital — Boston
  • Minneapolis Heart Institute — Minneapolis
  • Catholic Medical Center — Manchester

Identifiers

NCT: NCT04552275 · 2020P001793

Primary sources (government registries)

View this study on ClinicalTrials.gov ↗