Management of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block

Status

UNKNOWN

Phases

Study type

Interventional

Source

ClinicalTrials.gov

Registry ID

NCT01494870

Enrollment

300

Registered

2011-12-19

Start date

2012-01-31

Completion date

2013-11-30

Last updated

2012-01-10

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Acute Coronary Syndrome

Keywords

acute coronary syndrome, percutaneous coronary intervention, left bundle branch block

Brief summary

The primary objective of this study is to propose new treatment algorithm (strategy) for patients with Acute Coronary Syndrome (ACS) and left bundle-branch block (LBBB).

Detailed description

Current recommendations on the treatment of acute coronary syndrome (ACS) dictate urgent reperfusion therapy in the case of evolving myocardial infarction with ST-segment elevation (STEMI). Optimal use of PCI (preferably) or thrombolysis in this situation requires a rapid and correct diagnosis. According to the ESC'2008 and ACC/AHA'2009 focused update guidelines patients admitted to the hospital within 12 hours after the onset of chest pain with new (or presumably new) left bundle-branch block (LBBB) should be treated like patients having STEMI (class I, level A). However, it is well-known that in patients with concomitant LBBB, the ECG manifestations of acute myocardial injury may be masked. ACS may occur in a patient with true old LBBB (when doctor has/has not an ability to compare the new ECG with the previous one) or (presumably) new LBBB. There is a high risk of non receiving appropriate therapy or of receiving inappropriate therapy (thrombolysis instead of LMWH/UFH/fondaparinux).

Interventions

PROCEDUREPCI

urgent PCI on admission

Study design

Allocation

Intervention model

SINGLE_GROUP

Primary purpose

TREATMENT

Masking

NONE

Eligibility

Sex/Gender

ALL

Age

18 Years to 75 Years

Healthy volunteers

Inclusion criteria

* Age 18 - 75 years * Ischemic discomfort (ie, ischemic chest pain or equivalent) at rest ≥20 minutes within previous 24 hours. * Any (new, presumably new, or old) LBBB on the prehospital (ambulance) or admission ECG. * Urgent coronary angiography (followed, when indicated, by PCI), ideally within 90 minutes after admission

Exclusion criteria

* all-comers design

Design outcomes

Primary

Measure	Time frame
mortality	30 days

Secondary

Measure	Time frame
Number of participants survived	1 year

Countries

Russia

Contacts

Primary ContactDmitry Duplyakov, MD, PhD

duplyakov@yahoo.com+79277297273

Backup ContactIgor Yavelov, MD, PhD

yavelov@yahoo.com+79166059047

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026