Myocardial Oedema in Acute Myocardial Infarction (AMI)
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Purpose
Despite recent improvements in treatment, myocardial infarction (heart attack) is still a leading cause of illness and death in the UK. Following the acute event, it is difficult to predict which patients are at risk of further problems, such as heart failure and is therefore difficult to know which patients need more aggressive/intensive treatment and monitoring.
There needs to be a test which is safe, reliable and reproducible that can be used shortly after a heart attack to both predict future cardiac events and to allow the efficacy of new treatments to be assessed.
Myocardial oedema (swelling of the heart muscle) has been demonstrated using Cardiac Magnetic Resonance (CMR), to occur following a heart attack and has been suggested as a marker for future cardiac events. The optimum time to perform this scan, the method of data analysis and it's effectiveness as a predictor of future cardiac events has not been adequately assessed.
This trial will assess the amount and natural time-course of oedema in the first 10 days following a heart attack. It will also correlate the amount of oedema with the size of scar (damaged heart muscle) and left ventricular ejection fraction (heart function) at 3 months to assess if it is a predictive marker.
| Condition |
|---|
|
Myocardial Infarction |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Retrospective |
| Official Title: | Determination of the Time Course of Myocardial Oedema Post Myocardial Infarction Treated With Primary Angioplasty Using Cardiac Magnetic Resonance Imaging |
- Extent and time course of myocardial oedema over the first 10 days post MI [ Time Frame: Days 1, 3 and 10 post MI ] [ Designated as safety issue: No ]
- Left ventricular ejection fraction and left ventricular scar size at 3 months [ Time Frame: 90 days post MI ] [ Designated as safety issue: No ]
| Enrollment: | 20 |
| Study Start Date: | November 2009 |
| Study Completion Date: | October 2011 |
| Primary Completion Date: | June 2011 (Final data collection date for primary outcome measure) |
| Groups/Cohorts |
|---|
|
Post MI patients
Patients recruited following a successfully reperfused myocardial infarction using primary angioplasty.
|
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients admitted to The London Chest Hospital following an ST elevation myocardial infarction who have been successfully treated with primary angioplasty.
Inclusion Criteria:
- Patients presenting to the London Chest Hospital with acute ST elevation myocardial infarction and treated with primary angioplasty and stent implantation within 12 hours of symptom onset
- Acute PCI / stent implantation has been successful (residual stenosis visually < 30% and TIMI flow ≥ 2)
- At the time of inclusion, the patient no longer requires intravenous catecholamines or mechanical hemodynamic support (aortic balloon pump)
- Serum troponin >1ng/ml 12 hours after onset of pain
- The patient is able to give written informed consent
- The patient must be able to understand and communicate in English
Exclusion Criteria:
- Known cardiomyopathy
- Previous documented myocardial infarction
- Previous percutaneous coronary intervention or coronary artery bypass surgery
- Significant renal dysfunction (EGFR<30)
- Systemic steroid therapy
- Current non steroidal anti-inflammatory drug use
- Chronic inflammatory disease
- Neoplastic disease without documented remission within the past 5 years
- Pregnancy
- Reduced mental capacity leading to inability to obtain informed consent
- Participation in another clinical trial within the last 30 days
Contacts and Locations| United Kingdom | |
| The London Chest Hospital | |
| London, Greater London, United Kingdom, E2 9JX | |
| Principal Investigator: | Thomas R Burchell, BSc, MB BS | Bart's and The London NHS Trust, United Kingdom |
More Information
Publications:
| Responsible Party: | Barts & The London NHS Trust |
| ClinicalTrials.gov Identifier: | NCT00987259 History of Changes |
| Other Study ID Numbers: | BLT006964 |
| Study First Received: | September 29, 2009 |
| Last Updated: | January 31, 2013 |
| Health Authority: | United Kingdom: National Health Service |
Keywords provided by Barts & The London NHS Trust:
|
Myocardial infarction Myocardial oedema Magnetic resonance |
Additional relevant MeSH terms:
|
Edema Infarction Myocardial Infarction Signs and Symptoms Ischemia Pathologic Processes |
Necrosis Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases |
ClinicalTrials.gov processed this record on May 16, 2013