Cardiovascular Diseases Clinical Trial
Official title:
Changes in Myocardial Biomechanics and Early Short-term Doxycycline Therapy in Patients With Acute Primary Anterior STEMI (ST Segment Elevation Myocardial Infarction)
The purpose of the study is to investigate the changes of myocardial biomechanics and efficacy of doxycycline in patients with primary anterior STEMI.
It is known that MMPs (matrix metalloproteinases) take part in myocardial remodeling, which
lead to the adverse remodeling of left ventricular. Doxycycline inhibiting MMPs and it help
to prevent collagen degradation and following LV (left ventricular) dilatation. Some
experimental studies on rat models have suggested an anti-remodeling effect of doxycycline in
myocardial infarction by means of decrease in activity of MMPs-2 and recovery of contractile
function of myocardium. The clinical trial was performed at 2013 (D.Antoniucci), but it was a
single study and confirmed theoretical and experimental background.
The study is randomized, opened, controlled. 45 patients with the first anterior STEMI will
be enrolled. On admission all patients will receive reperfusion therapy during the first 24
h. Patients will be randomized by the open envelope method and after that some of the
participants will be on doxycycline (100 mg b.i.d. for 7 days) in addition to routine medical
therapy for STEMI, but other will be on routine medical therapy of STEMI. After that they
will have echocardiography at 3-d, 7-th, 14-th days and 6 month after STEMI. The
investigators will evaluate left ventricular function of these patients by routine and
speckle-tracking echocardiography, incidence of cardiovascular end points (death, recurrent
myocardial infarction, angina, heart failure, stroke) and their combinations, also the
investigators will take blood samples to assess metalloproteinases (MMPs) and other
biomarkers.
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