ST-Elevation Myocardial Infarction Clinical Trial
Official title:
Endothelin Receptor Blockade in Acute ST-elevation Myocardial Infarction
Background and Objective: Acute coronary syndrome is characterized by compromised blood flow
at the epicardial and microvascular levels. The aim of the present study is to investigate
the effect of ET-receptor blockade by BQ-123 on myocardial perfusion and infarct size as an
adjunct to PCI-reperfusion therapy in patients with STEMI.
Patients are randomized to receive periinterventional intravenous BQ-123 or placebo.
Background and Objective: Acute coronary syndrome is characterized by compromised blood flow
at the epicardial and microvascular levels. We have previously shown that thrombectomy in
ST-elevation myocardial infarction (STEMI) accelerates ST-segment resolution, possibly by
preventing distal embolization. Therefore, we analyzed the vasoconstrictor concentration of
acute coronary thrombi, and found high concentrations of endothelin (ET) which correlated
with the magnitude of ST-segment resolution within one hour of percutaneous coronary
intervention (PCI). Furthermore, ET-receptor blockade by tezosentan significantly repressed
vasoconstriction in an in-vitro model using porcine coronary artery rings incubated with
coronary thrombus homogenates extracted from STEMI patients.
The aim of the present study is to investigate the effect of ET-receptor blockade by BQ-123
on myocardial perfusion and infarct size as an adjunct to PCI-reperfusion therapy in
patients with STEMI.
Methods: Fifty eligible patients will be randomized to receive periinterventional
intravenous BQ-123 or placebo. The primary endpoint of the study will be microvascular
function evaluated by cardiac magnetic resonance tomography.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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