Acute Myocardial Infarction
Conditions
Keywords
Ischemia, Reperfusion, Myocardial infarction, Postconditioning
Brief summary
We previously demonstrated that postconditioning by coronary angioplasty can decrease infarct size (as measured by cardiac enzyme release) in patients with ongoing acute myocardial infarction. It is currently unknown whether postconditioning actually decreases or simply delays myocardial cell death during reperfusion. In addition, the long term effects of postconditioning on recovery of myocardial contraction remains elusive. The objective of the present study is to determine whether infarct size reduction by angioplasty postconditioning is maintained at 6 months and whether functional recovery is improved at one year post-infarction.
Detailed description
Randomized, controlled, single-blinded trial comparing postconditioning to control (no intervention). Postconditioning consists of four episodes of one minute inflation followed by one minute deflation of the angioplasty balloon, starting within one minute of reflow after direct stenting of the occluded coronary artery.
Interventions
PROCEDUREPostconditioning
Postconditioning during angioplasty
PROCEDUREstandard angioplasty
standard angioplasty without postconditioning
Sponsors
Hospices Civils de Lyon
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
* Male and female patients, aged more than 18, with suspected first acute myocardial infarction, within 6 hours of the onset of chest pain, with a need for emergency revascularization by angioplasty. Patients must display a fully occluded (TIMI zero flow) culprit coronary artery, absence of visible collaterals and exhibit TIMI flow \>2 after direct stenting by angioplasty.
Exclusion criteria
* Cardiac arrest or cardiogenic shock * occlusion of the circumflex coronary artery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Infarct size as measured by cardiac enzymes and MRI at day 5 to 7 | during 72 hours after angioplasty, and at day 5 to 7 |
Secondary
| Measure | Time frame |
|---|---|
| Myocardial contraction (LV ejection fraction, wall motion score index, strain rate) measured by echocardiography at 6 month. | at 6 month |
Countries
France
Outcome results
None listed