Myocardial Infarction, Myocardial Ischemia, NSTEMI, STEMI
Conditions
Brief summary
The purpose of the OPTIMISER Registry is to prospectively and retrospectively collect baseline, clinical and procedural data in patients who present with AMI and are treated with PCI as well as prospectively collect the clinical outcome data. Outcomes will be compared in different clinical subgroups. The impact of PCI in AMI in general as well as cardiovascular outcomes after AMI will be assessed.
Detailed description
* To assess procedural success and clinical outcomes among persons with AMI, who undergo PCI and/ or CABG for AMI (STEMI or NSTEMI) 1. Periprocedural outcomes/ complications, which will be analyzed, represent: final result (e.g. TIMI flow), stent expansion, dissections, perforations, prevalence of thrombus (assessed by angiography and intravascular imaging) 2. Short and long-term clinical outcomes of interest including: new AMI, unstable angina (UA), stent-/scaffold thrombosis, target lesion failure, target vessel revascularization, ischemia driven revascularization, repeat hospitalization, new/worsening heart failure, cardiogenic shock, stroke, bleedings, cardiovascular death and all-cause death. * To describe procedural and clinical performance of various balloon, stent and scaffold devices implanted in patients presenting with AMI during the afore mentioned period * To study the impact of different devices and strategies used for lesion preparation and PCI optimization strategies among patients undergoing PCI * To describe early and late angiographic and OCT-findings among coronary artery disease in patients with AMI treated with various metallic stent and scaffold devices * To assess possible predictors for coronary stent implantation or device failure * To evaluate the impact of different antithrombotic regimens on patient clinical outcomes * To study procedural and clinical outcomes among CAD patients requiring hemodynamic support using mechanical devices. * To describe economic implications (cost-effectiveness) of various interventional treatments for CAD.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Subject \>18 years of age * Individuals who are newly diagnosed with AMI or have been diagnosed with AMI (STEMI or NSTEMI) within the last 5 years (since 2016). * Subjects must be willing to sign a patient informed consent (PIC) OR a patient ́s relative/ proxy are willing to provide PIC or patients have signed the General Consent (GK).
Exclusion criteria
* Patient unwilling or unable to provide informed consent * Patients with no ACS/AMI (e.g. Takotsubo cardiomyopathy, acute heart failure not related to AMI)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Rate of major adverse cardiac and cerebrovascular events (MACCE) (including new AMI, stroke or cardiovascular death) at 1 year | at 1 year |
Secondary
| Measure | Time frame |
|---|---|
| Rate of major adverse limb events (MALE) | 1, 2, 5 and 10 years |
| Rate of major adverse cardiac and cerebrovascular events (MACCE) | 1, 2, 5 and 10 years |
| Rate of new AMI | 1, 2, 5 and 10 years |
| Rate of TIA or stroke | 1, 2, 5 and 10 years |
| Rate of stent thrombosis | 1, 2, 5 and 10 years |
| Rate of target vessel revascularization | 1, 2, 5 and 10 years |
| Rate of target lesion failure | 1, 2, 5 and 10 years |
| Rate of ischemia-driven revascularization | 1, 2, 5 and 10 years |
| Rate of unstable angina | 1, 2, 5 and 10 years |
| Rate of rehospitalization for recurrent angina | 1, 2, 5 and 10 years |
| Rate of periprocedural complications (e.g. coronary perforations, no- reflow) | 1, 2, 5 and 10 years |
| Rate of rehospitalisation for heart failure, resuscitated cardiac arrest or implantable cardioverter-defibrillator (ICD) implantation at follow- up. | 1, 2, 5 and 10 years |
| Rate of cardiovascular mortality | 1, 2, 5 and 10 years |
| Rate of all-cause mortality | 1, 2, 5 and 10 years |
| Rate of bleeding events (access site or non-access site related) according to the BARC classification. | 1, 2, 5 and 10 years |
| Rate of vascular complications (according to VARC criteria) | 1, 2, 5 and 10 years |
| Rate of new York Heart Association (NYHA) class | 1, 2, 5 and 10 years |
| Rate of cardiogenic shock | 1, 2, 5 and 10 years |
| Rate of acute renal failure | 1, 2, 5 and 10 years |
| Rate of new atrial fibrillation | 1, 2, 5 and 10 years |
| Rate of new ventricular arrhythmias | 1, 2, 5 and 10 years |
| Rate of hospitalization for heart failure | 1, 2, 5 and 10 years |
Countries
Switzerland