Myocardial Infarction
Conditions
Keywords
Aldosterone Antagonist, Myocardial Infarction, Cardiac remodeling, Gene polymorphism, Remodeling Marker, Stress Marker
Brief summary
Early treatment of Myocardial Infarction patients with mineralocorticoid receptor antagonist with help reduces the incidence of cardiac remodeling and development into heart failure. Also studying aldosterone synthase (CYP11B2) and mineralocorticoid receptor (NR3C2) gene polymorphisms in Egyptian Myocardial Infarction patients will help tailor medication therapy and optimize therapeutic effects with the least adverse effects.
Interventions
None listed
Sponsors
Ain Shams University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Inclusion criteria
* ST- segment elevation patients. * Patients who are candidate for add-on treatment with Mineralocorticoid receptor antagonists (MRAs) to improve cardiac remodeling. * Age of 18 years to 80 years. * Written informed consent of the subject to participate in the study.
Exclusion criteria
* Contraindications to Mineralocorticoid receptor antagonists (MRA) including: serum potassium \>5.5 mEq/L at initiation; CrCl ≤30 mL/minute; concomitant use of strong CYP3A4 inhibitors; concomitant use with potassium supplements or potassium-sparing diuretics. * Mild-to-severe valvular stenosis or severe (grade III/IV) valvular regurgitation * Pregnant or nursing women. * Non cardiac disorders associated with increased growth factor (e.g., HIV, Alzheimer, Crohn's disease, Cancer, glomerulonephritis, glomerulosclerosis, diabetic nephropathy, muscle atrophy, fibrotic conditions and burns). * Patients with chronic heart failure with reduced ejection fraction (LVEF \<40%).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Genetic polymorphism | 3 months | To investigate impact of genetic polymorphism in aldosterone synthase (CYP11B2), mineralocorticoid receptor (NR3C2) on pharmacological effect of MRAs in patients with STEMI through measurement of biochemical serum markers such as serum aldosterone, oxidative stress markers and cardiac remodeling markers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Gene Interaction | 3 months | To investigate the potential interaction between these target gene polymorphisms and the overall patients' clinical outcome in response to treatment with Mineralocorticoid receptor antagonists (MRAs). |
| Gene incidence | 3 months | To detect the incidence of aldosterone synthase (CYP11B2) and mineralocorticoid receptor (NR3C2) gene polymorphisms in Egyptian patients with ST- segment elevation (STEMI). |
Countries
Egypt
Contacts
Primary ContactIsel Al-ansary, Bachelor Degree
Backup ContactNeven Sarhan, PhD
Outcome results
None listed