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Multicenter, Randomized, Double-blind, Placebo-controlled Study to Evaluate the Long Term Efficacy and Safety of Oral Tolvaptan Tablets in Subjects Hospitalized withWorsening Congestive Heart Failure - EVEREST

Conditions
Subjects hospitalized with worsening congestive heart failure (CHF).
Registration Number
EUCTR2005-002306-39-LT
Lead Sponsor
Otsuka Maryland Research Institute, Inc.
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
ot Recruiting
Sex
All
Target Recruitment
3600
Inclusion Criteria

1. Age greater than or equal to 18 years.
2. Current hospitalization for chronic congestive heart failure with admission up to 48 hours prior to randomization. Chronic heart failure is defined as requiring treatment for a minimum of 30 days prior to hospitalization.
3. The subject must have signs of extracellular volume expansion, defined as two or more of the following: a) jugular venous distention; b) pitting edema (>1+); or c) dyspnea at the time of randomization.
4. NYHA Class III or IV at the time of hospitalization.
5. Most recent LVEF < 40% within one year.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. Women who will not adhere to the reproductive precautions as outlined in the Informed Consent form.
2. Positive urine pregnancy test.
3. Inability to provide written informed consent.
4. Cardiac surgery within 60 days of potential study enrollment, excluding percutaneous coronary interventions.
5. Planned revascularization procedures, electrophysiologic (EP) device implantation, cardiac mechanical support implantation, cardiac transplantation, or other cardiac surgery within 30 days following study enrollment.
6. Subjects who are on cardiac mechanical support.
7. History of bi-ventricular pacer placement within the last 60 days.
8. Co-morbid condition with an expected survival less than six months.
9. Subjects with acute ST segment elevation myocardial infarction at the time of hospitalization.
10. History of sustained ventricular tachycardia or ventricular fibrillation within 30 days, unless in the presence of an automatic implantable cardioverter defibrillator.
11. History of a cerebrovascular accident within the last 30 days.
12. Hemodynamically significant uncorrected primary cardiac valvular disease.
13. Hypertrophic cardiomyopathy (obstructive or non-obstructive).
14. CHF due to uncorrected thyroid disease, active myocarditis or known amyloid cardiomyopathy.
16. History of primary significant liver disease or acute hepatic failure, as defined by the investigator.
17. Chronic uncontrolled diabetes mellitus as determined by the investigator.
18. Morbid obesity, defined as > 159 kg (or 350 lbs) or BMI > 42.
19. Supine systolic arterial blood pressure < 90 mmHg.
20. Serum creatinine > 3.5 mg/dL or > 309.4 µmol/L.
21. Serum potassium > 5.5 mEq/L or > 5.5 mmol/L.
22. Hemoglobin < 9 g/dL or < 90 g/L or 5.586 mmol/L.
23. History of hypersensitivity and/or idiosyncratic reaction to benzazepine derivatives (such as benazapril).
24. History of drug or medication abuse within the past year, or current alcohol abuse.
25. Inability to take oral medications.
26. Participation in another clinical drug or device trial where the last dose of drug was within the past
30 days or an investigational medical device is currently implanted.
27. Previous participation in this or any other tolvaptan clinical trial.
28. Subjects with refractory, end-stage, heart failure defined as subjects who are appropriate candidates for specialized treatment strategies, such as ventricular assist devices, continuous positive IV inotropic therapy, or hospice care.
29. Subjects currently treated with hemofiltration or dialysis.

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Secondary Outcome Measures
NameTimeMethod
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