Acute Myocardial Infarction
Conditions
Keywords
Acute myocardial infarction, Postconditioning, Sevoflurane
Brief summary
Ischemic postconditioning can reduce myocardial injury following myocardial infarction. A potential pharmacological agent is the anesthetic Sevoflurane. The investigators' hypothesis is that sevoflurane during primary percutaneous coronary intervention (PCI) will reduce infarct size.
Detailed description
Patients with first STEMI that will be treated by primary PCI, will be randomized to sedation with Sevoflurane during the procedure or to usual care.
Interventions
DRUGOxygen + Sevoflurane
Oxygen with end-tidal MAC of Sevoflurane 0.5 during PCI.
DRUGOxygen (placebo)
Control will receive oxygen only.
Sponsors
London Health Sciences Centre Research Institute OR Lawson Research Institute of St. Joseph's
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* First STEMI, presenting within 6 hours after the onset of chest pain * Symptoms lasting \> 30 minutes * Persistent ST-segment elevation \> 0.1 mV in 2 or more contiguous leads
Exclusion criteria
* Hypersensitivity to sevoflurane or other halogenated agents * Malignant hyperthermia * Cardiac arrest * Cardiogenic shock * Previous myocardial infarction or coronary bypass surgery * Pre-infarction angina * Heart failure (NYHA III/IV) * Chronic inflammatory disease * Severe renal impairment * Hepatic dysfunction * Use of Glyburide
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Infarct size by area under the curve of cardiac markers. | 3 days |
Secondary
| Measure | Time frame |
|---|---|
| ST segment elevation resolution | 90 minutes |
| TIMI flow | 60 minutes |
| Left ventricular function. | Six month |
| CRP | 24 hours |
| Patient satisfaction | 1 hour |
| Renal function | 48 hours |
Countries
Canada
Outcome results
None listed