ID

31328

Description

Study ID: 104574 Clinical Study ID: AR1104574 Study Title: A randomized blinded pilot trial of fondaparinux sodium (Arixtra®) versus unfractionated heparin in addition to standard therapy in a broad range of patients undergoing percutaneous coronary intervention (ASPIRE) Patient Level Data: Study Listed on ClinicalStudyDataRequest.com Clinicaltrials.gov Identifier: Sponsor: GlaxoSmithKline Collaborators: N/A Phase: Phase 2 Study Recruitment Status: Completed Generic Name: fondaparinux sodium Trade Name: Arixtra Study Indication: Thromboembolism

Keywords

Versions (1)
  1. 8/13/18 8/13/18 -
Copyright Holder

GlaxoSmithKline

Uploaded on

August 13, 2018

DOI

To request one please log in.

License

Creative Commons BY-NC 3.0
Model comments :

You can comment on the data model here. Via the speech bubbles at the itemgroups and items you can add comments to those specificially.

Back to model comments
Itemgroup comments for :

Item comments for :

In order to download data models you must be logged in. Please log in or register for free.

Fondaparinux sodium (Arixtra) versus unfractionated heparin with patients undergoing PCI; Clinical Study ID: AR1104574

English

Randomization Form

1 forms  
  1. StudyEvent: ODM
    1. Randomization Form
Administrative Data
Description

Administrative Data

Alias
UMLS CUI-1
C1320722
Patient ID, Centre No.
Description

Patient ID; Centre Number

Data type

text

Alias
UMLS CUI [1,1]
C1269815
UMLS CUI [1,2]
C2825181
UMLS CUI [1,3]
C1300638
Patient ID, Envelope No.
Description

Patient ID; Envelope Number

Data type

text

Alias
UMLS CUI [1,1]
C1269815
UMLS CUI [1,2]
C2348585
Patient Initials
Description

Patient Initials

Data type

text

Alias
UMLS CUI [1]
C2986440
Eligibility Assessment
Description

Eligibility Assessment

Alias
UMLS CUI-1
C0013893
All eligibility criteria met
Description

eligibility criteria fulfilled

Data type

boolean

Alias
UMLS CUI [1,1]
C1516637
UMLS CUI [1,2]
C1550543
Interventional cardiologist meets minimum experience criteria
Description

Interventional cardiologist; experience

Data type

boolean

Alias
UMLS CUI [1,1]
C0175906
UMLS CUI [1,2]
C0184661
UMLS CUI [1,3]
C0237607
Written informed consent obtained
Description

written informed consent

Data type

boolean

Alias
UMLS CUI [1,1]
C0021430
UMLS CUI [1,2]
C1547186
Blood drawn for admission laboratory tests including cardiac enzymes/markers
Description

admission laboratory test; cardiac enzymes/markers

Data type

boolean

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C0443763
UMLS CUI [1,3]
C1271630
Additional blood drawn for central evaluation of inflammatory and coagulation markers
Description

inflammatory and coagulation markers

Data type

boolean

Alias
UMLS CUI [1,1]
C0022885
UMLS CUI [1,2]
C0005778
UMLS CUI [1,3]
C3805088
Baseline ECG within 24 hours prior to acute PCI or 1 week if elective PCI
Description

Baseline ECG, before

Data type

boolean

Alias
UMLS CUI [1,1]
C1623258
UMLS CUI [1,2]
C1442488
UMLS CUI [1,3]
C0332152
Last Dose of Clopidogrel before PCI
Description

Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Dosage, Last

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0070166
UMLS CUI [1,4]
C0178602
UMLS CUI [1,5]
C1517741
mg
Last Dose of Clopidogrel before PCI, Date
Description

Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Dosage, Last

Data type

date

Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0070166
UMLS CUI [1,4]
C1762893
Last Dose of Clopidogrel before PCI, Time
Description

Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Time last dose

Data type

time

Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0070166
UMLS CUI [1,4]
C0946444
Last Dose of ASA before PCI
Description

Pretreatment, Percutaneous Coronary Intervention; ASA, dosage, last

Data type

float

Measurement units
  • mg
Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0004057
UMLS CUI [1,4]
C0178602
UMLS CUI [1,5]
C1517741
mg
Last Dose of ASA before PCI, date
Description

Pretreatment, Percutaneous Coronary Intervention; ASA, date last dose

Data type

date

Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0004057
UMLS CUI [1,4]
C1762893
Last Dose of ASA before PCI, time
Description

Pretreatment, Percutaneous Coronary Intervention; ASA, Time last dose

Data type

time

Alias
UMLS CUI [1,1]
C1532338
UMLS CUI [1,2]
C3539076
UMLS CUI [1,3]
C0004057
UMLS CUI [1,4]
C0946444
Weight in kilograms
Description

Body Weight

Data type

float

Measurement units
  • kg
Alias
UMLS CUI [1]
C0005910
kg
Treatment Allocation
Description

Treatment Allocation

Alias
UMLS CUI-1
C0034656
Investigator wishes to proceed with PCI
Description

undefined item

Data type

text

Has patient received a GPIIb/IIIa inhibitor or is there a plan for upfront use?
Description

GPIIb/IIIa inhibitor

Data type

boolean

Alias
UMLS CUI [1]
C3640054
Date patient randomized
Description

Randomization Date

Data type

date

Alias
UMLS CUI [1,1]
C0034656
UMLS CUI [1,2]
C0011008
Time patient randomized
Description

Randomization Time

Data type

time

Alias
UMLS CUI [1,1]
C0034656
UMLS CUI [1,2]
C0040223
Date study drug injected
Description

Study drug injection; date

Data type

date

Alias
UMLS CUI [1,1]
C3854006
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C0011008
Time study drug injected
Description

Study drug injection; time

Data type

time

Alias
UMLS CUI [1,1]
C3854006
UMLS CUI [1,2]
C3469597
UMLS CUI [1,3]
C0040223
Back to the top of the page

Similar models

Randomization Form

1 forms
  1. StudyEvent: ODM
    1. Randomization Form
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
Administrative Data
C1320722 (UMLS CUI-1)
Patient ID; Centre Number
Item
Patient ID, Centre No.
text
C1269815 (UMLS CUI [1,1])
C2825181 (UMLS CUI [1,2])
C1300638 (UMLS CUI [1,3])
Patient ID; Envelope Number
Item
Patient ID, Envelope No.
text
C1269815 (UMLS CUI [1,1])
C2348585 (UMLS CUI [1,2])
Patient Initials
Item
Patient Initials
text
C2986440 (UMLS CUI [1])
Item Group
Eligibility Assessment
C0013893 (UMLS CUI-1)
eligibility criteria fulfilled
Item
All eligibility criteria met
boolean
C1516637 (UMLS CUI [1,1])
C1550543 (UMLS CUI [1,2])
Interventional cardiologist; experience
Item
Interventional cardiologist meets minimum experience criteria
boolean
C0175906 (UMLS CUI [1,1])
C0184661 (UMLS CUI [1,2])
C0237607 (UMLS CUI [1,3])
written informed consent
Item
Written informed consent obtained
boolean
C0021430 (UMLS CUI [1,1])
C1547186 (UMLS CUI [1,2])
admission laboratory test; cardiac enzymes/markers
Item
Blood drawn for admission laboratory tests including cardiac enzymes/markers
boolean
C0022885 (UMLS CUI [1,1])
C0443763 (UMLS CUI [1,2])
C1271630 (UMLS CUI [1,3])
inflammatory and coagulation markers
Item
Additional blood drawn for central evaluation of inflammatory and coagulation markers
boolean
C0022885 (UMLS CUI [1,1])
C0005778 (UMLS CUI [1,2])
C3805088 (UMLS CUI [1,3])
Baseline ECG, before
Item
Baseline ECG within 24 hours prior to acute PCI or 1 week if elective PCI
boolean
C1623258 (UMLS CUI [1,1])
C1442488 (UMLS CUI [1,2])
C0332152 (UMLS CUI [1,3])
Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Dosage, Last
Item
Last Dose of Clopidogrel before PCI
float
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0070166 (UMLS CUI [1,3])
C0178602 (UMLS CUI [1,4])
C1517741 (UMLS CUI [1,5])
Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Dosage, Last
Item
Last Dose of Clopidogrel before PCI, Date
date
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0070166 (UMLS CUI [1,3])
C1762893 (UMLS CUI [1,4])
Pretreatment, Percutaneous Coronary Intervention; clopidogrel, Time last dose
Item
Last Dose of Clopidogrel before PCI, Time
time
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0070166 (UMLS CUI [1,3])
C0946444 (UMLS CUI [1,4])
Pretreatment, Percutaneous Coronary Intervention; ASA, dosage, last
Item
Last Dose of ASA before PCI
float
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0004057 (UMLS CUI [1,3])
C0178602 (UMLS CUI [1,4])
C1517741 (UMLS CUI [1,5])
Pretreatment, Percutaneous Coronary Intervention; ASA, date last dose
Item
Last Dose of ASA before PCI, date
date
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0004057 (UMLS CUI [1,3])
C1762893 (UMLS CUI [1,4])
Pretreatment, Percutaneous Coronary Intervention; ASA, Time last dose
Item
Last Dose of ASA before PCI, time
time
C1532338 (UMLS CUI [1,1])
C3539076 (UMLS CUI [1,2])
C0004057 (UMLS CUI [1,3])
C0946444 (UMLS CUI [1,4])
Body Weight
Item
Weight in kilograms
float
C0005910 (UMLS CUI [1])
Item Group
Treatment Allocation
C0034656 (UMLS CUI-1)
undefined item
Item
Investigator wishes to proceed with PCI
text
GPIIb/IIIa inhibitor
Item
Has patient received a GPIIb/IIIa inhibitor or is there a plan for upfront use?
boolean
C3640054 (UMLS CUI [1])
Randomization Date
Item
Date patient randomized
date
C0034656 (UMLS CUI [1,1])
C0011008 (UMLS CUI [1,2])
Randomization Time
Item
Time patient randomized
time
C0034656 (UMLS CUI [1,1])
C0040223 (UMLS CUI [1,2])
Study drug injection; date
Item
Date study drug injected
date
C3854006 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C0011008 (UMLS CUI [1,3])
Study drug injection; time
Item
Time study drug injected
time
C3854006 (UMLS CUI [1,1])
C3469597 (UMLS CUI [1,2])
C0040223 (UMLS CUI [1,3])
Back to the top of the page 

Contact

Please use this form for feedback, questions and suggestions for improvements.

Fields marked with * are required.

Help

Do you need help on how to use the search function? Please watch the corresponding tutorial video for more details and learn how to use the search function most efficiently.

Watch Tutorial