Cardiac Arrhythmia Suppression Trial (CAST)

This study has been completed.

Sponsor:

Information provided by:

National Heart, Lung, and Blood Institute (NHLBI)

ClinicalTrials.gov Identifier:

NCT00000526

First received: October 27, 1999

Last updated: June 23, 2005

Last verified: August 2004

History of Changes

Purpose

To determine whether drug treatment of asymptomatic ventricular arrhythmias in post-myocardial infarction patients reduced the incidence of sudden cardiac death and total mortality.

Condition	Intervention	Phase
Cardiovascular Diseases Coronary Disease Death, Sudden, Cardiac Heart Arrest Heart Diseases Myocardial Infarction Myocardial Ischemia Ventricular Arrhythmia	Drug: encainide Drug: flecainide Drug: moricizine	Phase 3

Study Type:	Interventional
Study Design:	Allocation: Randomized Masking: Double-Blind Primary Purpose: Prevention

Resource links provided by NLM:

MedlinePlus related topics: Arrhythmia Cardiac Arrest Coronary Artery Disease Heart Attack Heart Diseases

Drug Information available for: Moricizine hydrochloride Flecainide Flecainide acetate Encainide Encainide hydrochloride

U.S. FDA Resources

Further study details as provided by National Heart, Lung, and Blood Institute (NHLBI):

Study Start Date:	August 1986
Estimated Study Completion Date:	March 1998

Show Detailed Description

Eligibility

Ages Eligible for Study:	18 Years to 75 Years
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Men and women with ventricular premature depolarization six days to two years after the start of myocardial infarction.

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00000526

Sponsors and Collaborators

National Heart, Lung, and Blood Institute (NHLBI)

Investigators

Investigator:

Alfred Hallstrom

University of Washington

More Information

Publications:

Pratt CM, Moyé LA. The cardiac arrhythmia suppression trial. Casting suppression in a different light. Circulation. 1995 Jan 1;91(1):245-7. No abstract available.

Goldstein S, Brooks MM, Ledingham R, Kennedy HL, Epstein AE, Pawitan Y, Bigger JT. Association between ease of suppression of ventricular arrhythmia and survival. Circulation. 1995 Jan 1;91(1):79-83.

el-Sherif N, Denes P, Katz R, Capone R, Mitchell LB, Carlson M, Reynolds-Haertle R. Definition of the best prediction criteria of the time domain signal-averaged electrocardiogram for serious arrhythmic events in the postinfarction period. The Cardiac Arrhythmia Suppression Trial/Signal-Averaged Electrocardiogram (CAST/SAECG) Substudy Investigators. J Am Coll Cardiol. 1995 Mar 15;25(4):908-14.

[No authors listed] Preliminary report: effect of encainide and flecainide on mortality in a randomized trial of arrhythmia suppression after myocardial infarction. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. N Engl J Med. 1989 Aug 10;321(6):406-12.

Ruskin JN. The cardiac arrhythmia suppression trial (CAST). N Engl J Med. 1989 Aug 10;321(6):386-8. No abstract available.

Bigger JT Jr. The events surrounding the removal of encainide and flecainide from the Cardiac Arrhythmia Suppression Trial (CAST) and why CAST is continuing with moricizine. J Am Coll Cardiol. 1990 Jan;15(1):243-5. No abstract available.

Morganroth J, Bigger JT Jr, Anderson JL. Treatment of ventricular arrhythmias by United States cardiologists: a survey before the Cardiac Arrhythmia Suppression Trial results were available. Am J Cardiol. 1990 Jan 1;65(1):40-8.

Pratt CM, Moye LA. The Cardiac Arrhythmia Suppression Trial: background, interim results and implications. Am J Cardiol. 1990 Jan 16;65(4):20B-29B. Review.

Pratt CM. The Cardiac Arrhythmia Suppression Trial. Introduction: The aftermath of the CAST--a reconsideration of traditional concepts. Am J Cardiol. 1990 Jan 16;65(4):1B-2B. No abstract available.

Pratt CM, Brater DC, Harrell FE Jr, Kowey PR, Leier CV, Lowenthal DT, Messerli F, Packer M, Pritchett EL, Ruskin JN. Clinical and regulatory implications of the Cardiac Arrhythmia Suppression Trial. Am J Cardiol. 1990 Jan 1;65(1):103-5. No abstract available.

Pratt CM, Moye L. The cardiac arrhythmia suppression trial: implications for antiarrhythmic drug development. J Clin Pharmacol. 1990 Nov;30(11):967-74. No abstract available.

Bigger JT Jr. Implications of the Cardiac Arrhythmia Suppression Trial for antiarrhythmic drug treatment. Am J Cardiol. 1990 Feb 20;65(8):3D-10D; discussion 68D-71D.

Morganroth J, Bigger JT Jr. Pharmacologic management of ventricular arrhythmias after the cardiac arrhythmia suppression trial. Am J Cardiol. 1990 Jun 15;65(22):1497-503. No abstract available.

Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH, Arensberg D, Baker A, Friedman L, Greene HL, et al. Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. N Engl J Med. 1991 Mar 21;324(12):781-8.

Epstein AE, Bigger JT Jr, Wyse DG, Romhilt DW, Reynolds-Haertle RA, Hallstrom AP. Events in the Cardiac Arrhythmia Suppression Trial (CAST): mortality in the entire population enrolled. J Am Coll Cardiol. 1991 Jul;18(1):14-9. Erratum in: J Am Coll Cardiol 1991 Sep;18(3):888.

Wyse DG, Hallstrom A, McBride R, Cohen JD, Steinberg JS, Mahmarian J. Events in the Cardiac Arrhythmia Suppression Trial (CAST): mortality in patients surviving open label titration but not randomized to double-blind therapy. J Am Coll Cardiol. 1991 Jul;18(1):20-8.

Hallstrom AP, Verter J, Friedman L. Randomizing responders. Cardiac Arrhythmia Suppression Trial (CAST) investigators. Control Clin Trials. 1991 Aug;12(4):486-503.

Denes P, Gillis AM, Pawitan Y, Kammerling JM, Wilhelmsen L, Salerno DM. Prevalence, characteristics and significance of ventricular premature complexes and ventricular tachycardia detected by 24-hour continuous electrocardiographic recording in the Cardiac Arrhythmia Suppression Trial. CAST Investigators. Am J Cardiol. 1991 Oct 1;68(9):887-96.

Capone RJ, Pawitan Y, el-Sherif N, Geraci TS, Handshaw K, Morganroth J, Schlant RC, Waldo AL. Events in the cardiac arrhythmia suppression trial: baseline predictors of mortality in placebo-treated patients. J Am Coll Cardiol. 1991 Nov 15;18(6):1434-8.

Hallstrom AP, Greene HL, Huther ML. The healthy responder phenomenon in non-randomized clinical trials. CAST Investigators. Stat Med. 1991 Oct;10(10):1621-31.

Greene HL, Roden DM, Katz RJ, Woosley RL, Salerno DM, Henthorn RW. The Cardiac Arrhythmia Suppression Trial: first CAST ... then CAST-II. J Am Coll Cardiol. 1992 Apr;19(5):894-8.

[No authors listed] Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. N Engl J Med. 1992 Jul 23;327(4):227-33.

Akiyama T, Pawitan Y, Campbell WB, Papa L, Barker AH, Rubbert P, Friedman L, Keller M, Josephson RA. Effects of advancing age on the efficacy and side effects of antiarrhythmic drugs in post-myocardial infarction patients with ventricular arrhythmias. The CAST Investigators. J Am Geriatr Soc. 1992 Jul;40(7):666-72.

Shea S, Bigger JT Jr, Campion J, Fleiss JL, Rolnitzky LM, Schron E, Gorkin L, Handshaw K, Kinney MR, Branyon M. Enrollment in clinical trials: institutional factors affecting enrollment in the cardiac arrhythmia suppression trial (CAST). Control Clin Trials. 1992 Dec;13(6):466-86.

Willund I, Gorkin L, Pawitan Y, Schron E, Schoenberger J, Jared LL, Shumaker S. Methods for assessing quality of life in the cardiac arrhythmia suppression trial (CAST). Qual Life Res. 1992 Jun;1(3):187-201.

Reynolds-Haertle RA, McBride R. Single vs. double data entry in CAST. Control Clin Trials. 1992 Dec;13(6):487-94.

Gorkin L, Schron EB, Brooks MM, Wiklund I, Kellen J, Verter J, Schoenberger JA, Pawitan Y, Morris M, Shumaker S. Psychosocial predictors of mortality in the Cardiac Arrhythmia Suppression Trial-1 (CAST-1). Am J Cardiol. 1993 Feb 1;71(4):263-7.

Peters RW, Zoble RG, Liebson PR, Pawitan Y, Brooks MM, Proschan M. Identification of a secondary peak in myocardial infarction onset 11 to 12 hours after awakening: the Cardiac Arrhythmia Suppression Trial (CAST) experience. J Am Coll Cardiol. 1993 Oct;22(4):998-1003.

Epstein AE, Hallstrom AP, Rogers WJ, Liebson PR, Seals AA, Anderson JL, Cohen JD, Capone RJ, Wyse DG. Mortality following ventricular arrhythmia suppression by encainide, flecainide, and moricizine after myocardial infarction. The original design concept of the Cardiac Arrhythmia Suppression Trial (CAST). JAMA. 1993 Nov 24;270(20):2451-5.

Friedman LM, Bristow JD, Hallstrom A, Schron E, Proschan M, Verter J, DeMets D, Fisch C, Nies AS, Ruskin J, et al. Data monitoring in the cardiac arrhythmia suppression trial. Online J Curr Clin Trials. 1993 Jul 31;Doc No 79:[5870 words; 53 paragraphs]

Peters RW, Mitchell LB, Brooks MM, Echt DS, Barker AH, Capone R, Liebson PR, Greene HL. Circadian pattern of arrhythmic death in patients receiving encainide, flecainide or moricizine in the Cardiac Arrhythmia Suppression Trial (CAST). J Am Coll Cardiol. 1994 Feb;23(2):283-9.

Wyse DG, Morganroth J, Ledingham R, Denes P, Hallstrom A, Mitchell LB, Epstein AE, Woosley RL, Capone R. New insights into the definition and meaning of proarrhythmia during initiation of antiarrhythmic drug therapy from the Cardiac Arrhythmia Suppression Trial and its pilot study. The CAST and CAPS Investigators. J Am Coll Cardiol. 1994 Apr;23(5):1130-40.

Hochman JS, Brooks MM, Morris M, Ahmad T. Prognostic significance of left ventricular aneurysm in the Cardiac Arrhythmia Suppression Trial (CAST) population. Am Heart J. 1994 Apr;127(4 Pt 1):824-32.

Denes P, el-Sherif N, Katz R, Capone R, Carlson M, Mitchell LB, Ledingham R. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Am J Cardiol. 1994 Aug 1;74(3):216-20.

Anderson JL, Platia EV, Hallstrom A, Henthorn RW, Buckingham TA, Carlson MD, Carson PE. Interaction of baseline characteristics with the hazard of encainide, flecainide, and moricizine therapy in patients with myocardial infarction. A possible explanation for increased mortality in the Cardiac Arrhythmia Suppression Trial (CAST). Circulation. 1994 Dec;90(6):2843-52.

Brooks MM, Gorkin L, Schron EB, Wiklund I, Campion J, Ledingham RB. Moricizine and quality of life in the Cardiac Arrhythmia Suppression Trial II (CAST II). Control Clin Trials. 1994 Dec;15(6):437-49.

Kennedy HL, Brooks MM, Barker AH, Bergstrand R, Huther ML, Beanlands DS, Bigger JT, Goldstein S. Beta-blocker therapy in the Cardiac Arrhythmia Suppression Trial. CAST Investigators. Am J Cardiol. 1994 Oct 1;74(7):674-80.

Hallstrom A, Pratt CM, Greene HL, Huther M, Gottlieb S, DeMaria A, Young JB. Relations between heart failure, ejection fraction, arrhythmia suppression and mortality: analysis of the Cardiac Arrhythmia Suppression Trial. J Am Coll Cardiol. 1995 May;25(6):1250-7.

Pratt CM, Ed: A Symposium: the Cardiac Arrhythmia Suppression Trial--Does it Alter Our Concepts of and Approaches to Ventricular Arrhythmias? Am J Cardiol, 65:1-42B, 1990.

Akiyama T, Pawitan Y, Greenberg H, Kuo CS, Reynolds-Haertle RA. Increased risk of death and cardiac arrest from encainide and flecainide in patients after non-Q-wave acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial. CAST Investigators. Am J Cardiol. 1991 Dec 15;68(17):1551-5.

Hallstrom AP, Anderson JL, Carlson M, Davies R, Greene HL, Kammerling JM, Romhilt DW, Duff HJ, Huther M. Time to arrhythmic, ischemic, and heart failure events: exploratory analyses to elucidate mechanisms of adverse drug effects in the Cardiac Arrhythmia Suppression Trial. Am Heart J. 1995 Jul;130(1):71-9.

Friedmann E, Thomas SA. Pet ownership, social support, and one-year survival after acute myocardial infarction in the Cardiac Arrhythmia Suppression Trial (CAST). Am J Cardiol. 1995 Dec 15;76(17):1213-7.

Roose SP, Glassman AH. Antidepressant choice in the patient with cardiac disease: lessons from the Cardiac Arrhythmia Suppression Trial (CAST) studies. J Clin Psychiatry. 1994 Sep;55 Suppl A:83-7; discussion 88-9, 98-100. Review.

Josephson RA, Chahine RA, Morganroth J, Anderson J, Waldo A, Hallstrom A. Prediction of cardiac death in patients with a very low ejection fraction after myocardial infarction: a Cardiac Arrhythmia Suppression Trial (CAST) study. Am Heart J. 1995 Oct;130(4):685-91.

Peters RW, Brooks MM, Todd L, Liebson PR, Wilhelmsen L. Smoking cessation and arrhythmic death: the CAST experience. The Cardiac Arrhythmia Suppression Trial (CAST) Investigators. J Am Coll Cardiol. 1995 Nov 1;26(5):1287-92.

Kellen JC, Ettinger A, Todd L, Brezsnyak ML, Campion J, McBride R, Thomas S, Corum J, Schron E. The Cardiac Arrhythmia Suppression Trial: Implications for nursing practice. Am J Crit Care. 1996 Jan;5(1):19-25.

Schron EB, Brooks MM, Gorkin L, Kellen JC, Morris M, Campion J, Shumaker SA, Corum J. Relation of sociodemographic, clinical, and quality-of-life variables to adherence in the cardiac arrhythmia suppression trial. Cardiovasc Nurs. 1996 Mar-Apr;32(2):1-6.

Peters RW, Brooks MM, Zoble RG, Liebson PR, Seals AA. Chronobiology of acute myocardial infarction: cardiac arrhythmia suppression trial (CAST) experience. Am J Cardiol. 1996 Dec 1;78(11):1198-201.

Goldstein S, Zoble RG, Akiyama T, Cohen JD, Lancaster S, Liebson PR, Rapaport E, Goldberg AD, Peters RW, Gillis AM. Relation of circadian ventricular ectopic activity to cardiac mortality. CAST Investigators. Am J Cardiol. 1996 Oct 15;78(8):881-5.

Obias-Manno D, Friedmann E, Brooks MM, Thomas SA, Haakenson C, Morris M, Wimbush F, Somelofski C, Goldner F. Adherence and arrhythmic mortality in the cardiac arrhythmia suppression trial (CAST). Ann Epidemiol. 1996 Mar;6(2):93-101.

Gorkin L, Schron EB, Handshaw K, Shea S, Kinney MR, Branyon M, Campion J, Bigger JT Jr, Sylvia SC, Duggan J, Stylianou M, Lancaster S, Ahern DK, Follick MJ. Clinical trial enrollers vs. nonenrollers: the Cardiac Arrhythmia Suppression Trial (CAST) Recruitment and Enrollment Assessment in Clinical Trials (REACT) project. Control Clin Trials. 1996 Feb;17(1):46-59.

Anderson JL, Karagounis LA, Stein KM, Moreno FL, Ledingham R, Hallstrom A. Predictive value for future arrhythmic events of fractal dimension, a measure of time clustering of ventricular premature complexes, after myocardial infarction. CAST Investigators. Cardia Arrhythmia Suppression Trial. J Am Coll Cardiol. 1997 Jul;30(1):226-32.

Thomas SA, Friedmann E, Wimbush F, Schron E. Psychological factors and survival in the cardiac arrhythmia suppression trial (CAST): a reexamination. Am J Crit Care. 1997 Mar;6(2):116-26.

Shumaker SA, Brooks MM, Schron EB, Hale C, Kellen JC, Inkster M, Wimbush FB, Wiklund I, Morris M. Gender differences in health-related quality of life among postmyocardial infarction patients: brief report. CAST Investigators. Cardiac Arrhythmia Suppression Trials. Womens Health. 1997 Spring;3(1):53-60.

Every NR, Hlatky MA, McDonald KM, Weaver WD, Hallstrom AP. Estimating the proportion of post-myocardial infarction patients who may benefit from prophylactic implantable defibrillator placement from analysis of the CAST registry. Cardiac Arrhythmia Suppression Trial. Am J Cardiol. 1998 Sep 1;82(5):683-5, A8.

Hallstrom A, Friedman L, Denes P, Rizo-Patron C, Morris M. Do arrhythmia patients improve survival by participating in randomized clinical trials?. Observations from the Cardiac Arrhythmia Suppression Trial (CAST)and the Antiarrhythmics Versus Implantable Defibrillators Trial (AVID). Control Clin Trials. 2003 Jun;24(3):341-52.

ClinicalTrials.gov Identifier:	NCT00000526 History of Changes
Other Study ID Numbers:	45
Study First Received:	October 27, 1999
Last Updated:	June 23, 2005
Health Authority:	United States: Federal Government

Additional relevant MeSH terms:

Arrhythmias, Cardiac
Cardiovascular Diseases
Myocardial Ischemia
Coronary Artery Disease
Coronary Disease
Death, Sudden
Heart Arrest
Heart Diseases
Infarction
Ischemia
Myocardial Infarction
Death, Sudden, Cardiac
Pathologic Processes
Vascular Diseases

Arteriosclerosis
Arterial Occlusive Diseases
Death
Necrosis
Flecainide
Moricizine
Encainide
Anti-Arrhythmia Agents
Cardiovascular Agents
Therapeutic Uses
Pharmacologic Actions
Sodium Channel Blockers
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on February 14, 2013

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