Myocardial Infarction Clinical Trial
Official title:
Clinical Trial Appreciating Intramyocardial Haemorrhage in Patients With Primary STEMI and Different Reperfusion Strategies (Pharmaco Invasive Strategy and Primary PCI)
The purpose of the study is to assess the frequency and intensity of intramyocardial haemorrhage in patients with primary STEMI and different reperfusion strategies.
The study non-randomized, opened, controlled. In half of patients despite on carried in-time
reperfusion therapy intramyocardial haemorrhage determined after a long-term period of severe
ischemia. Earlier, definition of intramyocardial haemorrhage was possible only by autopsy.
Nowaday, cardiac contrast MRI is the best diagnostic method, which allows to assess the
regional and global function of the LV, structural changes in myocardial tissue and also in
T2 mode it became assessable to reveal intramyocardial haemorrhage.
Taking into account the results of previous researches, it can be concluded that the
intramyocardial haemorrhage was determined in half of patients with primary PCI [1]. An
influence of fibrinolytic therapy to the intramyocardial haemorrhage was conducted in small
group of patients in one trial, and therefore further data will be actual and useful [2].
It is planned to study 60 patients with primary STEMI using standard therapy. The patients
will be divided into 2 groups. Patients of the 1st group will be treated by pharmaco-invasive
strategy. The 2nd group will be treated by primary PCI. Patients in all groups after
reperfusion strategies will be conducted cardiac contrast MRI for detection intramyocardial
haemorrhage within 2 days onset. At day 7 and through 3 months, the clinical condition of the
patients will be assessed and cardiac ultrasound will be performed for the evaluation of
myocardial contractile function and 2D global longitudinal strain. Also, the incidence rate
of secondary endpoints will be evaluated.
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