NCT04864795

Brief Summary

The CARE-HK in HF is a registry study based on the hypothesis that adherence to guidelines is associated with improved real-world outcomes for heart failure (HF) patients. For the purpose of this study, adherence to guidelines is defined as adherence to RAASi treatment recommendations, according to the AHA/ACC and ESC guidelines. Objectives relating to patiromer effectiveness will only be evaluated if a sufficient number of patients are available. The study aims to evaluate in patients at high risk of hyperkalaemia; patients treated with ACEi/ARB/ARNi, and either treated with or candidates for treatment with MRA.

Trial Health

93
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
2,636

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Apr 2021

Typical duration for all trials

Geographic Reach
7 countries

116 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 6, 2021

Completed
13 days until next milestone

Study Start

First participant enrolled

April 19, 2021

Completed
10 days until next milestone

First Posted

Study publicly available on registry

April 29, 2021

Completed
2.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

February 29, 2024

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 30, 2024

Completed
Last Updated

November 4, 2024

Status Verified

April 1, 2024

Enrollment Period

2.9 years

First QC Date

April 6, 2021

Last Update Submit

October 31, 2024

Conditions

Outcome Measures

Primary Outcomes (3)

  • Percentage of patients by RAASi optimisation

    overall

    at 6-months intervals

  • Percentage of patients by RAASi dose modification following hyperkalaemic episodes

    RAASi

    at 6-month intervals after a hyperkalaemic episode

  • Comparison of percentage of patients with RAASi treatment optimisation between patiromer treated and untreated patients following hyperkalaemic

    episodes

    at 6-months following enrolment

Secondary Outcomes (3)

  • Occurrence and incidence of hyperkalaemia events by RAASi treatment optimisation

    at 6-months following enrolment

  • Description of physician provided reasons for treatment decisions at initiation or modification/discontinuation of RAASi treatment

    up to 6 months following enrolment

  • Description and change of disease status measured by patient reported outcome (PRO) by RAASi treatment optimisation

    at enrolment and at approximately 6-months intervals

Study Arms (1)

Single Cohort

Patient data will be collected from patient records and/or during a routine clinical visit. This will include treatments prescribed, routine assessments and measurements collected at routine clinical visits, as well as hospitalisations and other relevant patient data.

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

To the extent possible, representative sites (e.g., cardiologists and nephrologists) reflective of the treatment patterns within each country will be recruited. All patients treated for chronic HF during the enrolment period will be assessed for eligibility, and all eligible patients will be consecutively proposed to enrol in the study as they present for a routine clinical visit (in-person or virtual visits) in order to avoid potential selection bias.

You may qualify if:

  • Adult aged ≥18 years at enrolment.
  • Patient diagnosed with chronic HF ≥3 months prior to signature of informed consent.
  • Patient has at least 1 record of LVEF documented in patient medical record in the 24 months prior to signature of informed consent. NOTE: If the proportion of patients with HFpEF exceeds 20% of the target sample size, enrolment of patients with an LVEF ≥50% may be capped.
  • Patient treated with ACEi/ARB/ARNi at enrolment.
  • Patient treated with or a candidate for treatment with MRA per a relevant treatment guideline (e.g., HF, CKD, resistant hypertension) at enrolment.
  • Patient at increased risk of hyperkalaemia due to one or more of the following:
  • Current hyperkalaemia (sK+ \>5.0 mEq/l) at enrolment
  • Record of documented hyperkalaemia (sK+ \>5.0 mEq/l) in the 24 months prior to signature of informed consent
  • eGFR \<45 ml/min/1.73 m2, or CKD Stage ≥3b.
  • Patient judged by the Investigator to have sufficient cognitive ability to participate.
  • Signed informed consent provided

You may not qualify if:

  • Patient on renal replacement therapy or mechanical circulatory support.
  • Disease other than HF with expected survival \<1 year.
  • Patient is participating in, or being screened for, an interventional trial, with the exception of interventional trials relating to SARS-CoV-2.
  • Patient already found to be intolerant to MRA for reasons other than hyperkalaemia or renal impairment.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (116)

University of Arkansas for Medical Sciences

Little Rock, Arkansas, 72205, United States

Location

UC San Diego Sulpizio Cardiovascular Center

La Jolla, California, 92037, United States

Location

Amicis Research Center

Northridge, California, 91324, United States

Location

Bridgeport Hospital

Bridgeport, Connecticut, 06610, United States

Location

Bethesda Hospital East

Boynton Beach, Florida, 33425, United States

Location

Clearwater Cardiovascular Consultants

Clearwater, Florida, 33756, United States

Location

Innovative Research of West Florida, Inc.

Clearwater, Florida, 33756, United States

Location

Inpatient Research Clinic, LLC

Hialeah, Florida, 33013, United States

Location

Clearwater Cardiovascular Consultants

Largo, Florida, 33777, United States

Location

D&H National Research Centers

Miami, Florida, 33173, United States

Location

Southwest Florida Research, LLC

Naples, Florida, 34102-8143, United States

Location

Peace River Cardiovascular Center

Port Charlotte, Florida, 33952, United States

Location

Clearwater Cardiovascular and Interventional Consultants

Safety Harbor, Florida, 32695, United States

Location

Florida Cardiology P.A

Winter Park, Florida, 32792, United States

Location

IACT Health

Columbus, Georgia, 31904, United States

Location

Cardiology Care Clinics

Eatonton, Georgia, 31024, United States

Location

NSC Research

Johns Creek, Georgia, 30024, United States

Location

Chicago Medical Research, LLC

Hazel Crest, Illinois, 60429-2196, United States

Location

Prairie Cardiovascular Consultants, Ltd.

Springfield, Illinois, 62701, United States

Location

Cardiovascular Medicine, P.C.

Davenport, Iowa, 52803, United States

Location

Central Cardiology Associates

Elizabethtown, Kentucky, 42701, United States

Location

Maine Health

Biddeford, Maine, 04005, United States

Location

Johns Hopkins University

Baltimore, Maryland, 21218, United States

Location

TidalHealth Peninsula Regional Inc.

Salisbury, Maryland, 21801, United States

Location

Ascension St. Mary's Hospital

Saginaw, Michigan, 48601, United States

Location

Minneapolis Heart Institute Foundation

Minneapolis, Minnesota, 55407, United States

Location

St. Louis Heart and Vascular

Bridgeton, Missouri, 63044, United States

Location

Saint Luke's Hospital of Kansas City

Kansas City, Missouri, 64111, United States

Location

St. Louis University

St Louis, Missouri, 63104, United States

Location

Logan Health Research

Kalispell, Montana, 59901, United States

Location

Virtua Medical Group PA

Marlton, New Jersey, 08053-4197, United States

Location

Raritan Bay Primary and Cardiology Associates

Matawan, New Jersey, 07747, United States

Location

The Heart House

Sewell, New Jersey, 08080, United States

Location

Albany Stratton VA Medical Center

Albany, New York, 12208, United States

Location

Capital Cardiology Associates

Albany, New York, 12211, United States

Location

South Shore University Hospital

Bay Shore, New York, 11706, United States

Location

Focus Clinical Research Solutions

Charlotte, North Carolina, 28204, United States

Location

Nephrology Associates of Greater Cincinnati

Cincinnati, Ohio, 45236, United States

Location

Rama Research LLC

Marion, Ohio, 43302, United States

Location

The Heart and Medical Center

Durant, Oklahoma, 74701, United States

Location

Capital Area Research, LLC

Camp Hill, Pennsylvania, 17011, United States

Location

UPMC Presbyterian Hospital

Pittsburgh, Pennsylvania, 15213, United States

Location

UT Southwestern Medical Center

Dallas, Texas, 75390, United States

Location

East Texas Cardiology PA

Houston, Texas, 77002, United States

Location

Biopharma Informatic, LLC

Houston, Texas, 77084, United States

Location

Texas Cardiology Associates of Houston

Kingwood, Texas, 77339, United States

Location

Complete Heart Care

McKinney, Texas, 75071, United States

Location

Baylor Scott & White Round Rock

Round Rock, Texas, 78665, United States

Location

Baylor Scott & White Health - Temple

Temple, Texas, 76508, United States

Location

Victoria Heart & Vascular Center

Victoria, Texas, 77901, United States

Location

Richmond Cardiology Associates

Mechanicsville, Virginia, 23116, United States

Location

William S. Middleton Memorial VA Hospital

Madison, Wisconsin, 53705, United States

Location

KH St. Josef Braunau

Braunau am Inn, Austria

Location

LKH Universitatklinikum Graz

Graz, Austria

Location

Ordensklinkum Linz Elisabethinen

Linz, Austria

Location

Allgemeines Krankenhaus der Stadt Wien

Vienna, Austria

Location

Imed-19 privat

Vienna, Austria

Location

Klinik Floridsdorf

Vienna, Austria

Location

Cliniques Universitaires de Bruxelles Hopital Erasme

Brussels, Belgium

Location

Cliniques Universitaires Saint-Luc

Brussels, Belgium

Location

Grand Hôpital de Charleroi

Charleroi, Belgium

Location

AZ Sint-Blasius

Dendermonde, Belgium

Location

CHU de Liège

Liège, Belgium

Location

AZ Glorieux

Ronse, Belgium

Location

Azienda Ospedaliera Universitaria Policlinico Sant'Orsola Malpighi IRCCS

Bologna, Italy

Location

Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (Presidio Spedali Civili)

Brescia, Italy

Location

Azienda Ospedaliera Universitaria Arcispedale Sant'Anna

Ferrara, Italy

Location

Azienda Ospedaliero Universitaria Ospedali Riuniti di Foggia

Foggia, Italy

Location

A.O.U. Policlinico di Modena

Modena, Italy

Location

Centro Cardiologico Monzino-IRCCS

Monza, Italy

Location

Azienda Ospedaliera Universitaria "Federico II"

Napoli, Italy

Location

Azienda Ospedaliero Universitaria Pisana

Pisa, Italy

Location

Arcispedale S. Maria Nuova Azienda Ospedaliera di Reggio Emilia

Reggio Emilia, Italy

Location

IRCCS San Raffaele Pisana

Roma, Italy

Location

IRCCS Ospedale Policlinico San Martino

San Martino, Italy

Location

Azienda Servizi Sanitari 1 Triestina

Trieste, Italy

Location

Hospital Universitario Severo Ochoa

Leganés, Madrid, Spain

Location

Hospital Universitario Puerta de Hierro Majadahonda

Majadahonda, Madrid, Spain

Location

Complejo Hospitalario de Navarra

Pamplona, Navarre, Spain

Location

Hospital Universitario Central de Asturias

Oviedo, Principality of Asturias, 33011, Spain

Location

Complejo Hospitalario Universitario A Coruña

A Coruña, Spain

Location

Hospital Universitari Germans Trias i Pujol

Badalona, Spain

Location

Hospital clinic de Barcelona

Barcelona, Spain

Location

Hospital de la Santa Creu i Sant Pau

Barcelona, Spain

Location

Hospital Universitari de Bellvitge

Barcelona, Spain

Location

Hospital Universitari Vall d'Hebron

Barcelona, Spain

Location

Hospital Universitario Virgen de las Nieves

Granada, Spain

Location

Juan Ramon Jimenez Hospital

Huelva, Spain

Location

Complejo Hospitalario de Jaen

Jaén, Spain

Location

Hospital Universitario de Gran Canaria Dr. Negrin

Las Palmas de Gran Canaria, Spain

Location

Hospital Universitario Clinico San Carlos

Madrid, Spain

Location

Hospital Universitario Infanta Leonor

Madrid, Spain

Location

Hospital Universitario La Paz

Madrid, Spain

Location

Hospital Universitario Ramon y Cajal

Madrid, Spain

Location

Hospital Clinico Universitario Virgen de la Victoria

Málaga, Spain

Location

Hospital Universitario Puerto Real

Puerto Real, Spain

Location

Hospital Universitario Virgen del Rocío

Seville, Spain

Location

Hospital Universitario Virgen Macarena

Seville, Spain

Location

Hosp. Universitari Sant Joan de Reus

Tarragona, Spain

Location

Kantonsspital Aarau AG

Aarau, Switzerland

Location

University Hospital Basel

Basel, Switzerland

Location

Hôpitaux Universitaires de Genève - HUG

Geneva, Switzerland

Location

Centre Hospitalier Universitaire Vaudois

Lausanne, Switzerland

Location

Luzerner Kantonsspital

Lucerne, Switzerland

Location

Kantonsspital St. Gallen

Sankt Gallen, Switzerland

Location

Buckinghamshire Healthcare NHS Trust

Amersham, United Kingdom

Location

Bradford Royal Infirmary

Bradford, United Kingdom

Location

Royal Devon and Exeter Hospital (Wonford)

Exeter, United Kingdom

Location

Northwick Park Hospital

Harrow, United Kingdom

Location

Royal Liverpool University Hospital

Liverpool, United Kingdom

Location

Barts Health NHS Trust

London, United Kingdom

Location

King's College Hospital

London, United Kingdom

Location

William Harvey Clinical Research Centre

London, United Kingdom

Location

Royal Victoria Infirmary

Newcastle, NE1 4LP, United Kingdom

Location

Derriford Hospital

Plymouth, United Kingdom

Location

Whiston Hospital

Rainhill, United Kingdom

Location

Related Publications (1)

  • Greene SJ, Sauer AJ, Bohm M, Bozkurt B, Butler J, Cleland JGF, Coats AJS, Desai NR, Grobbee DE, Kelepouris E, Pinto F, Rosano G, Donachie V, Fabien S, Waechter S, Crespo-Leiro MG, Hulsmann M, Kempf T, Pfister O, Pouleur AC, Saxena M, Schulz M, Volterrani M, Anker SD, Kosiborod MN. Management of patients with heart failure at high risk of hyperkalaemia: The CARE-HK in HF registry. Eur J Heart Fail. 2025 Nov;27(11):2410-2421. doi: 10.1002/ejhf.3800. Epub 2025 Aug 11.

MeSH Terms

Conditions

Heart FailureHyperkalemia

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesWater-Electrolyte ImbalanceMetabolic DiseasesNutritional and Metabolic Diseases

Study Officials

  • Sandra Wächter

    Vifor International

    STUDY CHAIR

Study Design

Study Type
observational
Observational Model
COHORT
Time Perspective
PROSPECTIVE
Target Duration
6 Months
Sponsor Type
INDUSTRY
Responsible Party
SPONSOR

Study Record Dates

First Submitted

April 6, 2021

First Posted

April 29, 2021

Study Start

April 19, 2021

Primary Completion

February 29, 2024

Study Completion

August 30, 2024

Last Updated

November 4, 2024

Record last verified: 2024-04

Data Sharing

IPD Sharing
Will share

Anonymized individual patient level data will be provided in a secure access environment upon approval of a research proposal and a signed data sharing agreement.

Shared Documents
STUDY PROTOCOL, SAP
Time Frame
Data can be requested 6 months after the primary publication for the entire prospective observation period. Data will be available 5 years for requesting.
Access Criteria
A research proposal must be approved by an independent review panel and the study sponsor and researchers must sign a data sharing agreement.

Locations