Cardiovascular Disease (CVD)WARMNCT03938155
Women's Advanced Risk-assessment in Manitoba
An observational study of Cardiovascular Disease (CVD) and Cardiovascular Risk Factor, run by St. Boniface Hospital at 1 site in Canada.
Trial summary
The main objective of this study is to test the ability of novel cardiovascular disease (CVD) prognostic tools to identify women at risk for future CVD. We plan to establish a cardiovascular health screening program at the St. Read more about this study
- Who is it for?
- Ages 55 years and older, women only
- Conditions the study is for
- Cardiovascular Disease (CVD), Cardiovascular Risk Factor, Vascular Stiffness
- How many people
- 1,000 participants
- Where
- 1 siteCanada
- Study dates
- 1 Oct 2019to Oct 2026
- How long will I take part?
- 5 Years
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 55 years and older
- Women only
- Adult, Older adult
Study population: One-thousand female participants 55 years of age or older will be recruited through a convenience sample method. Namely, we will utilize radio interviews on popular local stations to discuss the study as well as presentations at community events related to cardiovascular health. Articles will be published in a local newspaper and poster advertisements will also be placed in key locations related to the Winnipeg Regional Health Authority. Potential study participants interested in participating will contact the research coordinator in person, by email, or via telephone.
Who may be able to join
- women aged 55 and older
- possess a Manitoba Personal Health Information Number
Who cannot join
- Previous hospitalization or treatment for:
- Ischemic heart disease
- Acute myocardial infarction
- Stroke/Transient ischemic attack
- Percutaneous coronary intervention
- Coronary artery bypass surgery
Show all 13Show fewer
- Congestive heart failure
- Peripheral artery disease
- Congenital heart defects
- Arrhythmia
- Additional exclusion:
- Medical advice against physical activity
- Previous participant in the Assessment of Large and Small Artery Elasticity for the Early Detection of Cardiovascular Disease (NCT02863211)
Trial locations and contacts
1 site in 1 country.
Canada1 site, 1 recruiting
- Recruiting
St. Boniface Hospital Albrechtsen Research Centre
Winnipeg, Manitoba, R2H2A6
Todd Duhamel, PhD, 204-235-3589, tduhamel@sbrc.ca
Kevin Boreskie, MSc, 204-480-1815, kboreskie@sbrc.ca
About this study
Official title: Women's Advanced Risk-assessment in Manitoba (WARM) Hearts - Examining Cardiovascular Disease Risk in Middle Aged and Older Women
The main objective of this study is to test the ability of novel cardiovascular disease (CVD) prognostic tools to identify women at risk for future CVD. We plan to establish a cardiovascular health screening program at the St. Boniface Hospital and to test the efficacy of these tests for predicting adverse cardiovascular outcomes amongst a cohort of 1000 Manitoban women aged 55 years and older in the 5-year period after screening.
A second purpose of this project is to identify novel CVD biomarkers that may indicate a person is at risk for cardiovascular disease. Therefore, we plan to ask participants for permission to collect and store a sample of both their blood and stool for future research.
Read the detailed description
Women tend to develop heart disease approximately 10-15 years later than men, with a prevalence rate similar between sexes after women turn 55 years of age. Unfortunately, women have been under represented in cardiovascular disease (CVD) research, leading to the development of screening tools that are not able to adequately identify women at risk. Current methods of CVD risk in women in the clinical setting (Framingham Risk Score) underestimate this risk as compared to men. Thus, it appears that current screening tools are not sensitive to women's cardiovascular health, which may result in a missed diagnosis of CVD risk.
Efforts to prevent CVD focus on traditional risk factors (e.g. age, sex, smoking, cholesterol and blood pressure), which do estimate 10-year risk for heart attacks. However, this approach does not determine how well the cardiovascular system is functioning for individuals. A better approach may be the addition of non-invasive procedures to detect early stages of CVD for individual patients, which are not yet available in the primary care setting.
This project builds off of Dr. Duhamel's previous work looking at novel prognostic CVD testing in women, which successfully recruited 1030 women into "The Assessment of Large and Small Artery Elasticity for the Early Detection of Cardiovascular Disease trial (see ClinicalTrials.gov Identifier: NCT02863211)" trial in a 20 month period ending May 2017. Data from that research was presented at the 2018 Canadian Women's Heart Health Summit and identified that the addition of frailty assessments to health screening has the potential to identify women with elevated CVD risk. We are taking that knowledge forward and have developed this new trial to include additional frailty measurement approaches to determine if their addition further enhances CVD risk screening.
If this new research demonstrates that the proposed CVD risk screening approach is superior to the Framingham Risk Score (FRS) at identifying individuals who have early markers of cardiovascular disease, individuals with elevated CVD risk may be empowered to participate in interventions known to restore cardiovascular health.
Trial Objectives and Purpose
The main objective of this study is to test the ability of novel CVD prognostic tools to identify women at risk for future CVD. We plan to establish a cardiovascular health screening program at the St. Boniface Hospital and to test the efficacy of these tests for predicting adverse cardiovascular outcomes amongst a cohort of 1000 Manitoban women aged 55 years and older in the 5-year period after screening.
A second purpose of this project is to identify novel CVD biomarkers that may indicate a person is at risk for cardiovascular disease. Therefore, we plan to ask participants for permission to collect and store a sample of both their blood and stool for future research.
We are recruiting exclusively women for our study for several reasons. Women are often under-represented in cardiovascular clinical trials, which is an issue because their clinical presentation and prognosis of cardiovascular disease is different, as compared to men. For example, the assortment of traditional risk factors under estimate the risk of experiencing an adverse cardiovascular event in women, as compared to men. This is an issue because the standard method to predict future adverse cardiac events utilizes the traditional risk factors. Moreover, women who suffer a heart attack are more likely to die, have a second heart attack, develop heart failure, or consequentially suffer sudden cardiac death, as compared to men. Thus, it is important to develop new strategies to increase the predictive value of cardiovascular screening methods.
Recruitment of Subjects
We will recruit by convenience sample, 1000 Manitoban women 55 years of age and older with no previous history of CVD using print, online and media advertisements around the University of Manitoba and the Winnipeg Regional Health Authority during hosted events. Potential study participants interested in participating will contact the research coordinator in person, by email, or via telephone. The research coordinator will briefly describe the study and assess potential participants for eligibility in the study. Specifically, participants will be asked via telephone if they have been previously hospitalized for ischemic heart disease, acute myocardial infarction, stroke/transient ischemic attack, percutaneous coronary intervention, coronary artery bypass surgery, congestive heart failure, or peripheral artery disease previously).
They will then be invited to attend two testing appointments: one at the Active Living Centre at the University of Manitoba and then one at the Asper Clinical Research Institute approximately one week later. Written informed consent will be obtained after describing the nature of the study before enrolment. Sufficient time will be allowed for potential participants to provide their consent. The procedures for conducting informed consent will be documented in the study records and a copy of the signed consent will be given to the participants enrolled in the study.
Trial Design
A prospective, observational clinical trial design will be utilized to determine if the use of novel CVD prognostic tools identifies individuals that are at high risk for experiencing an adverse cardiovascular event in the 5-year period after screening.
Women that respond to the advertisements will be recruited to participate in the study. Each participant will complete the WARM Hearts protocol. A blood sample (15 ml) will also be taken to measure cholesterol, blood sugar, and novel blood-based biomarkers, such as epigenetic and genetic markers of cardiovascular disease risk. Stool samples will be collected in order to characterize the gut microbiome.
We plan to utilize each individual's Personal Health Information Number (PHIN) to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy Population Health Research Data Repository. The repository contains anonymized information, which is linkable across files through a fictitious number assigned to the records. We have defined adverse cardiovascular outcomes as hospitalization or death due to ischemic heart disease, acute myocardial infarction, stroke, transient ischemic attack, peripheral artery disease, percutaneous coronary intervention, coronary artery bypass surgery, congestive heart failure, prescription of cardiac medication, or new onset hypertension. This information will be assessed using information from the Manitoba Centre for Health Policy Population Health Research Data Repository and will be used to compare adverse cardiovascular events with the novel CVD screening tools to determine if they predicted which individuals were at moderate to high risk of an adverse cardiovascular event over the 5-year period after screening. All participants will be asked if they are willing to participate in future research studies. If they are, they may be contacted in regard to potential participation in additional studies conducted by the Duhamel lab group.
Study Procedures
After enrolment, patients will be asked to attend two visits approximately one week apart. Each appointment visit will last approximately 90 minutes and will comprise of the following:
- Demographic information
- Medical history
- Cognitive impairment
- Body composition, as characterized by bioelectrical impedance analysis and measurement of waist circumference
- Body mass index
- Grip strength
- Gait speed
- Fried frailty phenotype (self-reported exhaustion, unintentional weight loss, and Physical activity levels)
- Physical functioning as assessed by the Senior's Fitness Test
- Heart rate variability at rest and in response to six minutes of walking, with aerobic intensity assessed by accelerometer.
- A series of self-report questionnaires to characterize:
- Established cardiovascular risk factors
- Reproductive health (menstrual history, contraception use, pregnancy history, menopause status, hormone therapy use)
- Daily physical activity levels
- Quality of life
- Self-esteem
- Gender roles, relations and identity
- Sleep quality
- Nutrition intake
- Self-compassion
- Health anxiety
- Depression symptoms
- Blood sampling to measure cholesterol, blood glucose, and other markers of cardiovascular disease, such as but not limited to immune cell characterization
- Non-invasive measures of arterial stiffness
- Resting blood pressure
- Blood pressure in response to 3 minutes of moderate exercise
- Objectively assessed physical activity levels as measured by an accelerometer worn for approximately one week
- Stool sample collection to characterize gut microbiome
- Keywords
- female, humans, aged, cardiovascular system, cardiovascular diseases, cardiovascular diseases/epidemiology, early diagnosis, frailty, frailty elderly, prospective studies, Manitoba/epidemiology, gastrointestinal microbiome, cohort studies, cause of death, risk assessment, biomarkers, risk factors, pulse wave analysis, accelerometry, exercise
- Medical subject headings
- Cardiovascular Diseases, Disease, Frailty, Motor Activity, Coitus
What is being measured
The primary outcome is the main question the study is designed to answer.
Ischemic heart disease
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Acute myocardial infarction
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Stroke
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Transient ischemic attack
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Percutaneous coronary intervention
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Coronary artery bypass surgery
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Congestive heart failure
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Future diagnosis of hypertension
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Measured: 5 years post-screening
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 May 2019
- Study start1 Oct 2019
- Primary completion1 Oct 2021 (estimated)
- Study completionOct 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Cardiovascular Disease (CVD)Studies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,000 participants (estimated)
- Target duration
- 5 Years
Sponsor and investigators
- Lead sponsor
- St. Boniface Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Dr. Todd A Duhamel, St. Boniface Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03938155
- Sponsor's protocol ID
- HS22576 (H2019:063)
- Acronym
- WARM
- Status last verified
- Jan 2021
- First submitted
- 2 May 2019
- Last updated
- 28 Jan 2021
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: Initial WARM Hearts study data collection is expected to be complete in late 2021. Deidentified data will be available 6-months after that. Researchers wishing to access data should contact Dr. Todd Duhamel (tduhamel@sbrc.ca; orcid.org/0000-0001-8467-4800). A data dictionary will be available upon request. An itemized list of the data you are requesting with a brief proposal that outlines your justification, hypotheses, and proposed analyses will be required. Since biological samples represent a finite resource, the proposed analyses will be considered with regard to novelty, feasibility, and ethical approval. A Data Sharing Transfer Agreement or a Material Transfer Agreement must be signed and adhered to by collaborating parties and their respective institutions. Electronic data formats will be made available through the University of Manitoba Dataverse repository, following policies and procedures consistent with Tri-Council requirements.
Publications
Rose AV, Boreskie KF, Hay JL, Thompson L, Arora RC, Duhamel TA. Protocol for the WARM Hearts study: examining cardiovascular disease risk in middle-aged and older women - a prospective, observational cohort study. BMJ Open. 2021 May 25;11(5):e044227. doi: 10.1136/bmjopen-2020-044227.
PubMed 34035097
Study at a glance
From the registry record, last updated by the sponsor on 28 Jan 2021. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Women's Advanced Risk-assessment in Manitoba (WARM) Hearts - Examining Cardiovascular Disease Risk in Middle Aged and Older Women
- ClinicalTrials.gov ID
- NCT03938155
- Acronym / sponsor ID
- WARM / HS22576 (H2019:063)
- Keywords
- female, humans, aged, cardiovascular system, cardiovascular diseases, cardiovascular diseases/epidemiology, early diagnosis, frailty
- Study type
- Observational
- Recruitment status
- Unknown status
- Enrolment
- 1,000 participants (estimated)
- Lead sponsor
- St. Boniface HospitalUniversity, hospital or other
- Study start
- 1 Oct 2019 (actual)
- Primary completion
- 1 Oct 2021 (estimated)
- Study completion
- Oct 2026 (estimated)
- First posted
- 6 May 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The main objective of this study is to test the ability of novel cardiovascular disease (CVD) prognostic tools to identify women at risk for future CVD. We plan to establish a cardiovascular health screening program at the St. Boniface Hospital and to test the efficacy of these tests for predicting adverse cardiovascular outcomes amongst a cohort of 1000 Manitoban women aged 55 years and older in the 5-year period after screening.
A second purpose of this project is to identify novel CVD biomarkers that may indicate a person is at risk for cardiovascular disease. Therefore, we plan to ask participants for permission to collect and store a sample of both their blood and stool for future research.
Detailed description
Women tend to develop heart disease approximately 10-15 years later than men, with a prevalence rate similar between sexes after women turn 55 years of age. Unfortunately, women have been under represented in cardiovascular disease (CVD) research, leading to the development of screening tools that are not able to adequately identify women at risk. Current methods of CVD risk in women in the clinical setting (Framingham Risk Score) underestimate this risk as compared to men. Thus, it appears that current screening tools are not sensitive to women's cardiovascular health, which may result in a missed diagnosis of CVD risk.
Efforts to prevent CVD focus on traditional risk factors (e.g. age, sex, smoking, cholesterol and blood pressure), which do estimate 10-year risk for heart attacks. However, this approach does not determine how well the cardiovascular system is functioning for individuals. A better approach may be the addition of non-invasive procedures to detect early stages of CVD for individual patients, which are not yet available in the primary care setting.
This project builds off of Dr. Duhamel's previous work looking at novel prognostic CVD testing in women, which successfully recruited 1030 women into "The Assessment of Large and Small Artery Elasticity for the Early Detection of Cardiovascular Disease trial (see ClinicalTrials.gov Identifier: NCT02863211)" trial in a 20 month period ending May 2017. Data from that research was presented at the 2018 Canadian Women's Heart Health Summit and identified that the addition of frailty assessments to health screening has the potential to identify women with elevated CVD risk. We are taking that knowledge forward and have developed this new trial to include additional frailty measurement approaches to determine if their addition further enhances CVD risk screening.
If this new research demonstrates that the proposed CVD risk screening approach is superior to the Framingham Risk Score (FRS) at identifying individuals who have early markers of cardiovascular disease, individuals with elevated CVD risk may be empowered to participate in interventions known to restore cardiovascular health.
Trial Objectives and Purpose
The main objective of this study is to test the ability of novel CVD prognostic tools to identify women at risk for future CVD. We plan to establish a cardiovascular health screening program at the St. Boniface Hospital and to test the efficacy of these tests for predicting adverse cardiovascular outcomes amongst a cohort of 1000 Manitoban women aged 55 years and older in the 5-year period after screening.
A second purpose of this project is to identify novel CVD biomarkers that may indicate a person is at risk for cardiovascular disease. Therefore, we plan to ask participants for permission to collect and store a sample of both their blood and stool for future research.
We are recruiting exclusively women for our study for several reasons. Women are often under-represented in cardiovascular clinical trials, which is an issue because their clinical presentation and prognosis of cardiovascular disease is different, as compared to men. For example, the assortment of traditional risk factors under estimate the risk of experiencing an adverse cardiovascular event in women, as compared to men. This is an issue because the standard method to predict future adverse cardiac events utilizes the traditional risk factors. Moreover, women who suffer a heart attack are more likely to die, have a second heart attack, develop heart failure, or consequentially suffer sudden cardiac death, as compared to men. Thus, it is important to develop new strategies to increase the predictive value of cardiovascular screening methods.
Recruitment of Subjects
We will recruit by convenience sample, 1000 Manitoban women 55 years of age and older with no previous history of CVD using print, online and media advertisements around the University of Manitoba and the Winnipeg Regional Health Authority during hosted events. Potential study participants interested in participating will contact the research coordinator in person, by email, or via telephone. The research coordinator will briefly describe the study and assess potential participants for eligibility in the study. Specifically, participants will be asked via telephone if they have been previously hospitalized for ischemic heart disease, acute myocardial infarction, stroke/transient ischemic attack, percutaneous coronary intervention, coronary artery bypass surgery, congestive heart failure, or peripheral artery disease previously).
They will then be invited to attend two testing appointments: one at the Active Living Centre at the University of Manitoba and then one at the Asper Clinical Research Institute approximately one week later. Written informed consent will be obtained after describing the nature of the study before enrolment. Sufficient time will be allowed for potential participants to provide their consent. The procedures for conducting informed consent will be documented in the study records and a copy of the signed consent will be given to the participants enrolled in the study.
Trial Design
A prospective, observational clinical trial design will be utilized to determine if the use of novel CVD prognostic tools identifies individuals that are at high risk for experiencing an adverse cardiovascular event in the 5-year period after screening.
Women that respond to the advertisements will be recruited to participate in the study. Each participant will complete the WARM Hearts protocol. A blood sample (15 ml) will also be taken to measure cholesterol, blood sugar, and novel blood-based biomarkers, such as epigenetic and genetic markers of cardiovascular disease risk. Stool samples will be collected in order to characterize the gut microbiome.
We plan to utilize each individual's Personal Health Information Number (PHIN) to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy Population Health Research Data Repository. The repository contains anonymized information, which is linkable across files through a fictitious number assigned to the records. We have defined adverse cardiovascular outcomes as hospitalization or death due to ischemic heart disease, acute myocardial infarction, stroke, transient ischemic attack, peripheral artery disease, percutaneous coronary intervention, coronary artery bypass surgery, congestive heart failure, prescription of cardiac medication, or new onset hypertension. This information will be assessed using information from the Manitoba Centre for Health Policy Population Health Research Data Repository and will be used to compare adverse cardiovascular events with the novel CVD screening tools to determine if they predicted which individuals were at moderate to high risk of an adverse cardiovascular event over the 5-year period after screening. All participants will be asked if they are willing to participate in future research studies. If they are, they may be contacted in regard to potential participation in additional studies conducted by the Duhamel lab group.
Study Procedures
After enrolment, patients will be asked to attend two visits approximately one week apart. Each appointment visit will last approximately 90 minutes and will comprise of the following:
- Demographic information
- Medical history
- Cognitive impairment
- Body composition, as characterized by bioelectrical impedance analysis and measurement of waist circumference
- Body mass index
- Grip strength
- Gait speed
- Fried frailty phenotype (self-reported exhaustion, unintentional weight loss, and Physical activity levels)
- Physical functioning as assessed by the Senior's Fitness Test
- Heart rate variability at rest and in response to six minutes of walking, with aerobic intensity assessed by accelerometer.
- A series of self-report questionnaires to characterize:
- Established cardiovascular risk factors
- Reproductive health (menstrual history, contraception use, pregnancy history, menopause status, hormone therapy use)
- Daily physical activity levels
- Quality of life
- Self-esteem
- Gender roles, relations and identity
- Sleep quality
- Nutrition intake
- Self-compassion
- Health anxiety
- Depression symptoms
- Blood sampling to measure cholesterol, blood glucose, and other markers of cardiovascular disease, such as but not limited to immune cell characterization
- Non-invasive measures of arterial stiffness
- Resting blood pressure
- Blood pressure in response to 3 minutes of moderate exercise
- Objectively assessed physical activity levels as measured by an accelerometer worn for approximately one week
- Stool sample collection to characterize gut microbiome
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Target follow-up
- 5 Years
Who may qualify
- Ages
- 55 years and older
- Sex
- Female only
- Age groups
- Adult, Older adult
- Study population
- One-thousand female participants 55 years of age or older will be recruited through a convenience sample method. Namely, we will utilize radio interviews on popular local stations to discuss the study as well as presentations at community events related to cardiovascular health. Articles will be published in a local newspaper and poster advertisements will also be placed in key locations related to the Winnipeg Regional Health Authority. Potential study participants interested in participating will contact the research coordinator in person, by email, or via telephone.
Key inclusion criteria (2 listed)
- women aged 55 and older
- possess a Manitoba Personal Health Information Number
Key exclusion criteria (13 listed)
- Ischemic heart disease
- Acute myocardial infarction
- Stroke/Transient ischemic attack
- Percutaneous coronary intervention
- Coronary artery bypass surgery
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Ischemic heart disease
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Acute myocardial infarction
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Stroke
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Transient ischemic attack
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Percutaneous coronary intervention
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Coronary artery bypass surgery
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Congestive heart failure
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Future diagnosis of hypertension
Time frame: 5 years post-screening
Each individual's Personal Health Information Number (PHIN) will be utilized to follow the study participants and to determine if they experienced an adverse cardiovascular outcome using the Manitoba Centre for Health Policy (MCHP) Population Health Research Data Repository. Hospital separations abstracts, medical claims and the Drug Program Information Network will be examined to provide information on hospitalizations for cardiac diseases, cardiac procedures performed, cardiac-related and other medications used, and diagnoses with cardiac diseases. Vital statistics will also provide information on cause of death to allow for mortality rate tracking. This administrative health data will be used to compare adverse cardiovascular events with the WARM Hearts protocol results to determine if this cardiovascular screening approach predicted which individuals were at moderate to high risk of an adverse cardiovascular outcome over the five-year period after screening.
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Jan 2021.
- Derived from this study: PubMed 34035097Rose AV, Boreskie KF, Hay JL, Thompson L, Arora RC, Duhamel TA. Protocol for the WARM Hearts study: examining cardiovascular disease risk in middle-aged and older women - a prospective, observational cohort study. BMJ Open. 2021 May 25;11(5):e044227. doi: 10.1136/bmjopen-2020-044227.
- Individual participant dataSharing planned: Yes. Initial WARM Hearts study data collection is expected to be complete in late 2021. Deidentified data will be available 6-months after that. Researchers wishing to access data should contact Dr. Todd Duhamel (tduhamel@sbrc.ca; orcid.org/0000-0001-8467-4800). A data dictionary will be available upon request. An itemized list of the data you are requesting with a brief proposal that outlines your justification, hypotheses, and proposed analyses will be required. Since biological samples represent a finite resource, the proposed analyses will be considered with regard to novelty, feasibility, and ethical approval. A Data Sharing Transfer Agreement or a Material Transfer Agreement must be signed and adhered to by collaborating parties and their respective institutions. Electronic data formats will be made available through the University of Manitoba Dataverse repository, following policies and procedures consistent with Tri-Council requirements.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Cardiovascular Disease (CVD) and Cardiovascular Risk Factor, run by St. Boniface Hospital at 1 site in Canada.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 2 inclusion and 13 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 28 Jan 2021. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Canada. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Todd Duhamel, PhD (204-235-3589, tduhamel@sbrc.ca), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Ischemic heart disease (time frame: 5 years post-screening). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03938155, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Jan 2021.