Cyclarity Therapeutics Patient Questionnaire 1.0

Cyclarity Therapeutics Patient Questionnaire
Heart attacks and strokes, amongst other diseases, are usually caused by a process called “atherosclerosis”. This is the process by which our blood vessels (arteries) become clogged with fatty deposits, known as “plaques”. Plaque can reduce blood supply to affected organs, causing loss of function and sometimes pain. Chest pain (angina) is one example, due to limited blood supply to the heart. Eventually, blood supply to organs may be seriously disrupted, resulting in permanent damage, such as heart attacks or strokes.

There are many medications now available that can slow down the progression of atherosclerosis. Some also lower the risk of heart attacks and strokes in people with atherosclerosis. Cyclarity therapeutics is looking at new technology designed to reverse the processes of plaques (hardened areas) forming in the blood vessels.

We would be grateful if you could complete the following short questionnaire. This is aimed at patients with atherosclerosis and those close to them who may have been affected by knowing someone living with this disease. Please request more copies of the questionnaire if you need them. Your responses will be anonymous – we are not collecting details about who you are.
Exertional chest pain (angina)Heart attack (myocardial infarction; MI)“Mini-stroke” (transient ischaemic attack; TIA)StrokeHeart failure (reduced ability to pump blood)Carotid artery diseasePeripheral artery disease (sometimes causing vascular ulcers or calf pain on walking [claudication])Coronary artery diseaseAortic aneurysm
YesNoDon’t know
MeSomeone I’m close to
FemaleMaleOther / Prefer not to say
< 20 years20 years to < 40 years40 years to < 60 years60 years to < 80 years80 years or more
White – European DescentAny other White backgroundBlack - African DescentMixed – White and BlackAny other Mixed backgroundAny other Black backgroundEast AsianSouth AsianAny other Asian backgroundMixed – White and AsianIndigenousHispanic or LatinoArab or other Middle-EasternAny other ethnic backgroundPrefer not to say
Please specify:
YesNoDon't know
Very much worseModerately worseA little worseNo real change
Please briefly describe the aspect of the illnesses you selected above have affected YOUR life to the greatest extent.

0/1000
Blood pressure lowering drugsPlatelet inhibiting drugs or anticoagulantsCholesterol lowering drugs
Made it a lot worseMade it moderately worseMade no differenceMade it a little worseMade it a little betterMade it moderately betterMade it very much better
Please briefly describe how the affected person’s use of these medicines has affected YOUR life, including any barriers to use of the medicines or side effects:

0/1000
YesNoDon't know
What is the greatest strength of the current treatment options?:

0/1000
What is the greatest weakness of the current treatment options?:

0/1000
UnnecessarySatisfactoryGoodVery GoodExceptional / Amazing
As often as neededEvery day for two weeksEvery day for a weekEvery other day for two weeksTwice a week for a monthOnce a week for two monthsOnce a monthOccasionallyNot at all
If "not at all," please describe the apprehension with receiving an intravenous infusion to reverse atherosclerosis, reduce the risk of future events, and reduce the need for daily oral medication.

0/1000
Blood pressure lowering drugs
such as angiotensin-converting enzyme (ACE) inhibitors [e.g. enalapril, lisinopril, perindopril, ramipril], angiotensin receptor blockers (ARBs) [e.g. candesartan, irbesartan, losartan, valsartan, olmesartan], calcium channel blockers [e.g. amlodipine, felodipine, nifedipine], ‘water’ tablets / diuretics [e.g. indapamide, bendroflumethiazide], or beta-blockers [e.g. atenolol, bisoprolol].
Platelet inhibiting drugs
e.g. aspirin, clopidogrel, prasugrel, ticagrelor
Lipid regulating / lowering drugs
such as statins [e.g. atorvastatin, fluvastatin, pravastatin, rosuvastatin, simvastatin], cholesterol absorption inhibitors [e.g. ezetimibe], fibrates [e.g. bezafibrate, ciprofibrate, fenofibrate, gemfibrozil], PCSK9 inhibitors [e.g. evolocumab, alirocumab], or bile acid sequestrants [e.g. colestyramine, colestipol hydrochloride]
Something I definitely would doSomething I would like to doSomething I might doSomething I wouldn’t like to doSomething I definitely wouldn’t do
If "I wouldn't like to do" or "definitely wouldn't do," please explain why you would prefer not to take part in a clinical trial to test whether this drug could help patients.
In what country do you reside?
Please verify that you are human*
Should be Empty: