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Clinical Trial Summary

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


Clinical Trial Description

Acute myocardial infarction (AMI) with its accompanying adverse sequelae is one of the most common causes of morbidity and mortality in the world . Although reperfusion techniques for ST- elevation myocardial infarction (STEMI ) are constantly improving, no-reflow can still lead to poor prognosis . At present, the exact mechanism of no-reflow remains unclear, but clinical and laboratory findings suggest that it is related to the embolism of the capillary bed, ischemic injury, vascular endothelial dysfunction, production of oxygen free radical , and other factors . The no-reflow phenomenon is one of complications of poor functional and clinical outcomes for patients with (AMI) . The no-reflow phenomenon is present in 25% to 30% of patients with (AMI) underwent successful coronary recanalization, as shown by angiography . The myocardial no-reflow phenomenon is associated with a reducution of antegrade myocardial blood flow inspite of an open infarct-related artery in patients with (STEMI ) undergoing (PCI). Importantly, no-reflow is known to be related to unfavorable clinical outcome and prognosis . The cause of this complex phenomenon is the variable combination of four pathogenetic components: distal atherothrombotic embolization, ischemic injury, reperfusion injury and susceptibility of coronary microcirculation to injury . As a consequence, appropriate strategies are expected to prevent or treat these components are expected to avoid the no-reflow. Coronary reperfusion therapy is widely performed in patients with (AMI) . However, in spite of patency of the infarct-related artery , there is no guarantee of salvage of myocardium at risk of ischemia .The no-reflow phenomenon is found in >30% of patients after thrombolysis or catheter-based (PCI) for (AMI) . It is important, therefore, to be able to predict which lesions are high risk for no reflow before beginning PCI . There are numerous recognized risk factors for the development of coronary artery disease (CAD), one of the best known is the association between blood lipids and CAD . Several prospective studies have established that the risk of cardiac morbidity and mortality is directly related to the concentration of plasma cholesterol. ' The most prevalent view is that the increased risk of myocardial infarction associated with elevated plasma cholesterol levels can be adequately explained on the basis of the increase in number and severity of coronary atherosclerotic vascular lesions . . ;


Study Design


Related Conditions & MeSH terms


NCT number NCT04835974
Study type Interventional
Source Assiut University
Contact alzahraa gamal, master
Phone 01026181748
Email alzahraagamal@gmail.com
Status Not yet recruiting
Phase N/A
Start date May 1, 2021
Completion date May 2022

See also
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Completed NCT04785209 - Mean Platelet Volume and STEMI Clinical Risk Scores in Prediction of Impaired Myocardial Perfusion In Acute STEMI Patients Undergoing Primary Percutaneous Coronary Intervention.
Not yet recruiting NCT06342141 - Empagliflozin for No-reflow Phenomenon in PCI for STEMI Phase 2
Not yet recruiting NCT05360602 - Alpha Lipoic Acid Effect on No-Reflow Phenomenon N/A
Completed NCT02054000 - Intracoronary Tirofiban on No-Reflow Phenomena Phase 4
Not yet recruiting NCT05393557 - Upfront Premedication For Reduction of Microvascular Obstruction and No-reflow in Treating ST-segment Elevation Myocardial Infarction N/A
Completed NCT04699110 - Adrenaline for the Treatment of No-Reflow in Normotensive Patients Phase 4
Completed NCT04573751 - The EPIVER Randomized Controlled Trial N/A
Not yet recruiting NCT02233790 - Ticagrelor and Clopidogrel on Reperfusion in Patients With AMI Phase 4
Recruiting NCT05427786 - A Study to Evaluate the Impact of Pre-procedural Intracoronary Nicorandil Injection to PREVENT reductioN Of decREased TIMI FLOW in Patients Who Undergoing Percutaneous Coronary Intervention for the Coronary Artery Disease Phase 4
Completed NCT05355532 - Genetic Determinants of the Coronary Microvascular Obstruction in PCI