Acute Coronary Syndrome Clinical Trial
Official title:
Serial Measurements of High-sensitivity Cardiac Troponin T and Troponin I After Short, Controlled Induced Cardiac Ischemia
Background Troponin are proteins found in the cardiomyocyte and are a cornerstone in the
diagnoses of acute myocardial infarction. Troponin is released to the bloodstream as a result
of an cardiomyocyte injury. Troponin is frequently assessed in hospital care for patients
with chest pain and dyspnea.
Guidelines recommend troponin assessment at admission and repeated at 3 to 6 hours, depending
on the assay. High-sensitivity assays measure concentrations that are ten-times lower than
earlier generations of assays. However, the time from when troponin is elevated in the
bloodstream after an ischemic injury, measured with high-sensitivity assays, are not fully
known.
During an X-ray imaging of the heart's blood vessels (coronary angiogram) it is possible to
do a short, controlled occlusion of coronary artery by inflating a small balloon in one of
the coronary arteries. Numerous earlier studies in patients have used this method for induced
occlusion of one coronary artery for 1 to 3 minutes. Only one of the studies measured
troponin I.
The aim with this study is to quantify and compare the release of troponin T and troponin I
in the early hours after a controlled induced ischemia.
Study Design This is a prospective, descriptive and experimental study. There will be
included 40 patients, without acute ischemic cardiac disease. They will be randomized in 4
groups.
0: 10 patients - control group, no balloon occlusion
1. 10 patients - balloon occlusion for 30 seconds
2. 10 patients - balloon occlusion for 60 seconds
3. 10 patients - balloon occlusion for 90 seconds
Subsequently there will be assessed serial blood samples 0 - 3 hours: Every 15 minutes 3 - 6
hours: Every 30 minutes
Statistics This is a pilot study and it is estimated that ten patients are sufficient number
of patients in each group to assess elevation of troponin after occlusion of coronary artery.
The thesis is there is a dosage-response correlation between the length of balloon occlusion
and the concentration of troponin in blood stream.
n/a
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