Kalix

Researchers are evaluating whether remote video exercise-based cardiac rehabilitation (exCR) can increase participation in rehabilitation sessions after a myocardial infarction (heart attack), compared to traditional center-based exCR. The study is designed as a national multicenter registry-based cluster randomized crossover clinical trial, preceded by a feasibility and safety study conducted during the COVID-19 pandemic. Patients diagnosed with type 1 myocardial infarction and aged 18 to 79 years are included, with long-term follow-up planned at 1 and 3 years after the cardiac event. The study involves two phases: first, a feasibility study offering remote exCR at participating sites until the pandemic peak subsides, ending in August 2022; second, a randomized trial where cardiac rehabilitation centers are assigned to provide either remote exCR, usual center-based exCR, or a combination based on patient preference at intervention sites, while control sites offer only center-based exCR. The exercise program is standardized, requiring at least 24 supervised sessions over 3 to 4 months, each session including aerobic exercise and strength training at specified intensity levels. Success is defined as attending at least 75% of sessions within four months. Participants will be monitored through their attendance and adherence to the exercise sessions. Researchers will assess the average number of exCR sessions completed over 3 to 4 months. Additional evaluations include safety monitoring and long-term follow-up at 1 and 3 years to observe outcomes after the initial cardiac event. The study also considers patient access to internet for remote participation and evaluates exercise test results to ensure safety during rehabilitation.

Researchers are evaluating the safety and effectiveness of apixaban to prevent strokes in adults with stage 5 chronic kidney disease (CKD) who also have atrial fibrillation (AF), a heart rhythm disorder. This phase 3b clinical trial compares apixaban treatment to no anticoagulation to see if apixaban lowers the risk of ischemic stroke without causing unacceptable increases in fatal or brain bleeding. The study also looks at the risk of death from any cause, cardiovascular events, and major bleeding in this patient group. Participants are randomly assigned to receive either apixaban 2.5 mg tablets twice daily along with standard care or standard care without anticoagulation. The study is open-label, meaning both patients and doctors know the treatment given. Apixaban will be prescribed and renewed by the local investigator. The study lasts between 12 and 72 months and includes about 1000 to 1400 patients from multiple sites in Sweden, Finland, Norway, Iceland, Poland, and possibly other European countries. During the study, participants will have routine blood tests including kidney function and coagulation checks. Researchers will monitor the time to first ischemic stroke, fatal or intracranial bleeding, overall mortality, cardiovascular events, and major bleeding events. A safety board will oversee the trial, and outcomes will be reviewed independently. The study may also explore outcomes related to kidney transplant complications and thrombosis. Participation ends after 72 months or when enough primary events have occurred.

Researchers are studying the relationship between different levels of physical activity, sedentary time, and health outcomes in patients who have had a myocardial infarction (heart attack). The main goal is to understand how activity measured by accelerometers relates to clinical outcomes and how changes in physical activity over time affect these outcomes after a heart attack. The study plans to include about 4000 patients over two years who have experienced a myocardial infarction. Participants will wear an accelerometer device attached to their right hip during waking hours for seven consecutive days at two follow-up visits: once at 2 months and again at 1 year after hospital discharge. They will also keep a paper diary to record device wear time and working hours, then return both by mail. This process is repeated at the 1-year follow-up. During the study, participants attend follow-up visits where their physical activity data are collected and analyzed. Researchers will explore how different intensities of activity relate to major adverse cardiovascular events one year after the heart attack. Safety and adherence are monitored by collecting activity diaries and accelerometer data. Participation spans from hospital discharge through at least one year after the event to track outcomes and physical activity changes over time.