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Trial registered on ANZCTR
Registration number
ACTRN12625000608460
Ethics application status
Approved
Date submitted
18/04/2024
Date registered
12/06/2025
Date last updated
12/06/2025
Date data sharing statement initially provided
12/06/2025
Type of registration
Prospectively registered
Titles & IDs
Public title
Dose Titration Study: Assess the efficacy of dose titration in improving statin therapy following a heart attack
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Scientific title
Evaluate the effects of dose titration of statin therapy following non-ST elevation myocardial infarction on reducing side effects and enhancing adherence through a randomized controlled trial.
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Secondary ID [1]
311606
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non ST Elevation Myocardial Infarction
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Condition category
Condition code
Cardiovascular
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0
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Coronary heart disease
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Cardiovascular
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0
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Diseases of the vasculature and circulation including the lymphatic system
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention involves gradually adjusting the dose of statin medication for patients who have experienced a non-ST elevation myocardial infarction (NSTEMI). Starting with a lower dose, the medication will be titrated upward over time until the desired effect is achieved. This approach aims to minimize potential side effects associated with statin therapy while still providing the cardiovascular benefits.
The dose will be commenced at Atorvastatin 10mg daily and doubled every month for 4 months until a maximum dose of 80mg daily is obtained. 10mg daily for one month, 20mg daily for one month, 40mg daily for one month and 80m daily for one month.
The titrated dose will be continued for one month until a maximum dose is achieved and will be continued daily regularly
The administation will be an oral tablet
Drug adherence will be monitored by self reporting check list that will be provided to the patient that they can record when they have taken the medication and if they have any side effects and then a 6 monthly standard blood test will be done post their non ST elevation MI to assess lipid reduction (as per standard management protocol for NSTEMI)
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Intervention code [1]
328445
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Treatment: Drugs
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Comparator / control treatment
The control group will receive standard statin therapy at a fixed dose of 80mg. They will not undergo dose titration like the experimental group. This allows for comparison of outcomes between patients receiving standard therapy and those undergoing dose titration.
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Control group
Active
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Outcomes
Primary outcome [1]
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Primary Outcome: The primary outcome of the study is the change in lipid levels from baseline to the end of the 6-month study period.
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Assessment method [1]
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Assessment Method: The change in lipid levels will be assessed by comparing the baseline lipid levels obtained during routine blood tests performed as part of standard care for Non-ST Elevation Myocardial Infarction (NSTEMI) management with the lipid levels obtained at the end of the 6-month study period.
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Timepoint [1]
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Primary Time Point: The primary time point for assessing the change in lipid levels will be at the end of the 6-month study period post enrollment
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Secondary outcome [1]
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The secondary outcome of the study is patient adherence to statin therapy.
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Assessment method [1]
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2. Assessment Method: Patient adherence will be assessed using a combination of methods, including patient-reported adherence via monthly surveys, medication refill records, and pill counts during follow-up visits.
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Timepoint [1]
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Secondary Time Point: The time point for assessing patient adherence will be at the end of the 6-month study period (post enrollment)
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Eligibility
Key inclusion criteria
Key Inclusion Criteria:
1. Diagnosis of Non-ST Elevation Myocardial Infarction (NSTEMI)
2. Prescribed statin therapy as part of post-NSTEMI management
3. Ability to provide informed consent
4. Age 18 years or older
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Key Exclusion Criteria:
1. History of statin intolerance or allergy
2. Inability to adhere to the study protocol or complete required assessments
3. Contraindication to statin therapy
4. Severe comorbidities or conditions affecting life expectancy
5. Participation in another clinical trial involving lipid-lowering medications
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
allocation concealment involves using sealed envelopes prepared by an independent researcher.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Sequence generation employs computer-generated randomization by an impartial statistician.
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
18/06/2025
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Actual
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Date of last participant enrolment
Anticipated
19/09/2025
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Actual
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Date of last data collection
Anticipated
1/12/2026
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Actual
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Sample size
Target
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Sunshine Hospital, Western Health
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Sunshine Hospital, Western Health
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Address
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
318064
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Royal Melbourne Hospital Human Research Ethics Committee
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Ethics committee address [1]
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https://www.thermh.org.au/research/researchers/ethics
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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17/08/2023
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Approval date [1]
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01/11/2024
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Ethics approval number [1]
314760
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Summary
Brief summary
The primary purpose of this study is to see if titration of statin therapy can improve adherence and therefore outcomes while reducing the known side effects of statin therapy
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Mohammed Warraich
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Address
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Sunshine Hospital, Western Health 176 Furlong Rd, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 424626297
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Mohammed Warraich
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Address
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Sunshine Hospital, Western Health 176 Furlong Rd, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 424626297
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Mohammed Warraich
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Address
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Sunshine Hospital, Western Health 176 Furlong Rd, St Albans VIC 3021
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Country
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Australia
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Phone
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+61 424626297
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Fax
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Email
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
No IPD sharing reason/comment:
This has been changed. It will only be shared with those apart of the study. I.e Supervisor and Statistician
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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