Dehydration, Acute Myocardial Infarction, Renal Artery Stenosis
Conditions
Keywords
Dehydration, Primary PCI, Acute Myocardial Infarction, Bioimpedance, Renal Angiography
Brief summary
Aims: * evaluate the hydric status through bioimpedance spectroscopy in consecutive acute myocardial infarction patients referred for primary PCI; * assessment of renal artery stenosis incidence through renal angiography in consecutive STEMI patients; * fully characterize the complex hydration, metabolic and endothelial profile of these patients in the attempt to define the role played by dehydration in the complex dynamics of acute myocardial infarction.
Detailed description
Gathered data: * descriptive general demographic data; * previous pathologies (ischemic heart disease, peripheral arterial disease, stroke, heart failure, previous percutaneous coronary interventions, coronary artery bypass grafting - CABG, known renal disease); * cardiovascular risk factors (age, weight, height, abdominal perimeter, body mass index, smoking, sedentariness, diabetes, hypertension, dyslipidaemia); * routine biological data; * metabolic data (obtained from two body composition monitoring evaluations - before and 12 hours after coronary intervention) - body water, body fat tissue; * information regarding primary PCI (less than 12 hours of ischemic symptoms); * coronarographic details, type of used stent, periprocedural specific complications, final TIMI - thrombolysis in myocardial infarction - flow); * echocardiography at admission (LVEF); * renal arteries angiographic details performed in the same time with PCI (two independent operators evaluate stenosis based on a predefined scale); * renal diameters; * measurement of arterial stiffness through Sphigmocore pulsed-wave-velocity (24 hrs post-procedural, 2 velocities: carotid - femoral and carotid - radial); * in-hospital and one month follow-up MACE.
Interventions
using Fresenius device; two measurements before and after coronary intervention;
PROCEDURECoronarography
Preprocedural coronary arteriography is obtained after sterile preparation and draping of the patient, conscious sedation, infiltration of local anesthetic (lidocaine solution) at the femoral access site, placement of an arterial sheath in the femoral artery, and advancement of the renal guide catheter over a 0.035-in guidewire under fluoroscopic guidance. After the tip of the guide catheter is positioned at the ostium of the left coronary stem, an angiogram is obtained. After the guidewire is removed, the proximal end of the catheter is connected to a manifold, and 4-8 mL of contrast is manually injected during cineangiographic recording.
PROCEDUREPrimary Percutaneous Coronary Intervention
An intravenous antithrombotic agent, usually heparin, is administered before the clinician proceeds with angioplasty.
PROCEDURERenal Angiography
After the tip of the guide catheter is positioned at the ostium of the renal artery, an angiogram is obtained. After the guidewire is removed, the proximal end of the catheter is connected to a manifold, and 4-8 mL of contrast is manually injected during cineangiographic recording. This procedure is performed in the same time with primary PCI
Sponsors
Grigore T. Popa University of Medicine and Pharmacy
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* adults with ST elevation Myocardial Infarction (\<12h) diagnostic confirmed; * included in the Romanian National Programme of Primary Percutaneous Revascularisation (for who the Guidelines recommend primary PCI);
Exclusion criteria
* patients who do not sign informed consent for primary PCI
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Hydration Status in Acute Myocardial Infarction Patients (before and after p PCI) | 2 years | Assessment of hydration status through body composition monitoring BCM before and after coronary intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Renal Artery Stenosis | 2 years | Assessment of renal artery stenosis incidence in consecutive AMI patients; |
Countries
Romania
Contacts
Primary ContactAlexandru Burlacu, M.D.
Backup ContactAdrian Covic, Professor
Outcome results
None listed