NCT00968383

Cardiovascular Magnetic Resonance for the Occluded Infarct-Related Artery Treatment

Late Percutaneous Coronary Intervention of the Occluded Infarct-Related Artery in Patients With Preserved Infarct Zone Viability Determined With Magnetic Resonance Imaging

• Status: Terminated
• Phase: N/A
• Study type: Interventional
• Enrollment: 11 (actual)
• Sponsor: National Institute of Cardiology, Warsaw, Poland · Academic / Other
• Sex: All
• Age: 18 Years – 85 Years
• Healthy volunteers: Not accepted

Summary

The purpose of this study is to determine whether opening an occluded infarcted artery 3-28 days after an acute myocardial infarction in high-risk asymptomatic patients with preserved infarct zone viability improves left ventricular systolic function and volumes at 6 months follow-up. The secondary purpose is to assess the changes in myocardial tissue characteristics after late percutaneous coronary intervention (PCI).

Detailed description

Rapid restoration of blood flow in the infarct-related artery (IRA), one of the cornerstones of contemporary treatment of acute myocardial infarction (MI) prevents myocardial necrosis and its consequences. However, due to late presentation or failed fibrinolytic therapy up to one third of patients have persistently occluded IRA after MI. Recently, the Occluded Artery Trial (OAT) has demonstrated that percutaneous coronary intervention (PCI) with optimal medical therapy does not reduce the frequency of major adverse events compared to optimal medical therapy alone when performed on days 3-28 post MI in stable patients. Assessment of infarct zone viability was not used as an inclusion/exclusion criterion in the main OAT trial. Several studies confirm that patients with left ventricular systolic dysfunction and preserved myocardial viability (necrosis transmurality\<50% in most segments of the infarct zone) assessed with magnetic resonance imaging benefit from revascularization. Late opening of the occluded infarct-related artery only in patients with preserved myocardial tissue viability may lead to improvement of left ventricular volumes and function.

Conditions

• Cardiovascular Diseases
• Heart Diseases
• Myocardial Infarction
• Heart Failure

Interventions

Type	Name	Description
DRUG	Beta adrenergic blockers	Participants will receive beta adrenergic blockers.
DRUG	Platelet inhibitors	Participants will receive platelet inhibitors.
DRUG	Statins	Participants will receive statins.
DRUG	ACE inhibitors and/or ARB and/or AA	Participants will receive ACE inhibitors and/or ARB and/or AA
PROCEDURE	PCI with stenting	Participants will undergo percutaneous coronary intervention (PCI) and coronary stenting.

Timeline

• Start date: 2009-09-01
• Primary completion: 2012-12-01
• Completion: 2012-12-01
• First posted: 2009-08-31
• Last updated: 2015-05-14

Locations

1 site across 1 country: Poland