Active clinical trials for "Myocardial Infarction"

ST segment elevation myocardial infarction (STEMI) is one of the leading causes of death across the world and immediate treatment with either thrombolytics or percutaneous coronary intervention (PCI) results in lower mortality. It is essential to accurately determine the time of onset of myocardial infarction. Standard practice is to take the time of symptom onset as a surrogate for artery occlusion time. However symptom onset is a subjective parameter and affected by multiple factors such as recall issues in elderly patients and preceding unstable angina symptoms before artery occlusion. In a recent study by Mahmoud et al. an objective method, biochemical onset time is proposed for estimation of artery occlusion time using serial cardiac troponin T (cTnT) levels in patients with STEMI. However, this study was retrospective, had an average of two measurements of cTnT for each patient, peak troponin level was frequently missing and newer earlier detectable biomarkers such as high sensitive Troponin I (hsTnI) were not used. We plan to use multiple samples of hsTnI for each patient using the same method as above and we will compare the biochemical ischemic time with the patient reported symptom onset time. Secondarily, we will try to determine whether a single sample of multiple cardiac biomarkers with different release kinetics drawn at time of patient presentation in emergency room (ER) could predict precise time of onset of myocardial infarction. OBJECTIVES To determine the biochemical onset time using multiple hsTnI measurements from each patient (zero, 03, 08, 24 hrs), and compare this biochemical time to the patient-reported symptoms onset time as an indicator of coronary artery occlusion. To predict biochemical occlusion at the time of presentation with the use of single sample of six different markers of myocardial injury. To assess the association of conventional ischemic time and biochemical ischemic time with infarct size; using peak hsTnI, percent ejection fraction by Echocardiography and Cardiac Magnetic Resonance imaging (CMR) based infarct volume in grams. To assess the association of conventional ischemic time and biochemical ischemic time with in-hospital and 30-days major adverse cardiac events, MACE; a composite of heart failure, shock, re MI or death. A prospective nonintervention pilot study will include 100 consecutive patients coming with acute STEMI. Patients' recruitment will be done in ER of Tabba Heart Institute, Karachi Pakistan.

Background: Acute ischemic cardiovascular and cerebrovascular diseases are a kind of diseases with high incidence, rapid progression, poor prognosis and high mortality and disability rate of the circulatory system, mainly including acute myocardial infarction, acute ischemic stroke and acute limb ischemia, which place a heavy burden on individuals, families and society due to their severe prognosis and high medical costs. At present, the diagnosis and treatment of ischemic cardiovascular and cerebrovascular diseases mainly focus on single organ diagnosis and treatment of target organs, lacking of indicators to comprehensively evaluate the body's pathophysiology. As ischemic disease of the circulatory system, ischemic cardiovascular and cerebrovascular diseases have common pathophysiological basis such as ischemia, hypoxia and inflammation. These common pathophysiological basis suggests that different acute ischemic cardiovascular and cerebrovascular diseases can be monitored and evaluated from an integrated perspective, it suggests the possibility of comprehensive diagnosis, evaluation and treatment guidance. At present, the "circulatory integration" therapy represented by the combined treatment of heart and brain has achieved certain results, but there is no corresponding evaluation system to provide accurate guidance. Therefore, with the concept of "circulation integration", it is an urgent problem to find the common indicators of the circulation system and construct the hierarchical diagnosis and subsequent evaluation system of acute cardiovascular and cerebrovascular integration. The development of efficient and comprehensive stratified diagnosis and prognosis evaluation system is of great significance in clinical, market and social aspects. At the early stage of the efforts our team, it was found that Dan Shen Su-(±)-3, 4-dihydroxyphenylacetic acid (DSS) could be detected in the plasma and urine of patients with acute myocardial infarction and ischemic stroke through metabolomics. It has been proved that it can be generated by the transformation of dihydroxyphenylalanine by proteus mirabilis, and its structure is consistent with the water-soluble component of salvia miltiorrhiza, which is related to the body's states of ischemia, hypoxia and inflammation. The findings provide a material basis for the "circulatory integration" assessment of acute ischemic cardiovascular and cerebrovascular diseases. Objectives: This study aims at acute ischemic cardiovascular and cerebrovascular diseases, with the concept of "circulatory integration", to build a hierarchical diagnosis and prognosis evaluation system with DSS as the core, in order to improve the diagnosis rate and cure rate, improve the prognosis and reduce mortality of ischemic cardiovascular diseases. Methods: The project included 500 patients with acute myocardial infarction, 300 patients with acute ischemic stroke, 300 patients with acute lower limb ischemia, and 200 healthy controls in the Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, Peoples R China. Plasma and urine were collected during the disease process. Various relevant clinical indicators including DSS level were included, COX model was applied to analyze the influence of multiple factors on the prognosis of the above diseases, and the indicators were screened and the integrated stratified diagnosis and prognosis evaluation system of acute ischemic cardio-cerebrovascular system with DSS as the core were established. The newly established integrated stratified diagnosis and prognosis assessment system was used to evaluate 200 patients with each of the three diseases, and the sensitivity and specificity of the new assessment system were tested. And a simple, rapid and accurate method for detecting DSS was developed.

This study will evaluate the performance of the CorPath GRX System in Robotic Primary PCI (RPPCI) in the treatment of ST-elevated myocardial infarction (STEMI).

to find metabolic factors that correlate with the development of no-reflow phenomenon that may help prevent its occurrence

The goal of the study is to evaluate the Impact of coronary stent length and/or diameter in patients with ST segment myocardial infarction undergoing primary PCI, on Short term clinical outcomes.

In this study, clinical database and blood sample bank of acute chest pain (ACP) will be established at chest pain center of multi-center hospital. To explore new biomarkers and screen clinical indicators with effective risk stratification and prognostic evaluation for ACP through proteomics technology and statistics methods. Risk stratification and short-term and long-term prognostic evaluation models for high-risk ACP will be established using large data analysis.

Comparison of high PD1+ T cell and low PD1+ T cell expression in peripheral blood for cardiac function prognosis in Patients with acute myocardial infarction

The investigators would evaluate the effects of the novel method, HTEA on cardiac function in the heart failure patients secondary to idiopathic dilated cardiomyopathy and post-myocardial infarction.

The purpose of this study is to evaluate the predicting role of plasma GLP1 level on major adverse cardiovascular events (MACE) in patients with acute myocardial infarction who undergo percutaneous coronary intervention.

Current guidelines for the clinical management of hypertension in adults recommend to achieve and maintain blood pressure levels of <140/90 mmHg. However, it is uncertain what proportion of individuals identified with high blood pressure in primary care actually reach blood pressure control, what factors are associated with attainment of control and to what extent blood pressure control attainment is associated with cardiovascular diseases in a contemporary population of individuals diagnosed with high blood pressure. The aim of this study is to investigate the extent to which patients achieve blood pressure control and associated risk factors, time to attainment of blood pressure control and whether this time is associated with an increased risk of CVD onset, all-cause and cardiovascular disease and end-stage renal disease.