Assessment of Coronary Endothelial Function in Diabetic Patients With Acute Coronary Syndrome Using 15O-water Positron Emission Tomography

Study Overview
=================
Brief Summary
-----------------
Type 2 diabetes is associated with early and diffuse abnormalities of endothelial function, especially in the coronary arteries, which are a factor of poor prognosis. Following acute coronary syndrome, the endothelial function abnormalities usually persist for several weeks before regressing. Their persistence 6-8 weeks after myocardial infarction is a poor prognostic factor. Investigators assume that global abnormalities of endothelial function in patients with diabetes may be additive with segmental abnormalities in revascularized myocardium, and contribute to worsening the prognosis in these patients. Furthermore, there is no published data showing any relationship between calcium score and endothelial function abnormalities in these patients. The investigators seek a relationship between calcium score and persistence of abnormalities of coronary endothelial function in these patients. The main objective of this study was to compare coronary endothelial function by quantitative method (TEP at 15O-H2O) in diabetic patients and nondiabetic following acute coronary syndrome.

Conditions
-----------------
Myocardial Infarction

Intervention / Treatment
-----------------
* Other: Coronary endothelial function measurements by quantitative method (TEP at 15O-H2O)


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Patients with a first myocardial infarction, type 2 diabetic or non-diabetic treated by angioplasty in acute phase (TIMI 3) Myocardial viability test before discharge Age over 18 years Informed Consent dated and signed by the patient Written and spoken French Beneficiary of social security insurance Exclusion Criteria: Hypertension> 160/90 mmHg despite medical treatment Lack of effective revascularization in acute phase of myocardial infarction (TIMI grade <3) Significant three-vessel coronary artery disease (> 70% stenosis in the other two coronary arteries); occlusion of a coronary artery; schedule revascularization (percutaneous or surgical); left main coronary artery stenosis Previous history of myocardial infarction Mechanical complication (mitral regurgitation, ventricular septal rupture, left ventricular free wall rupture) Heart failure No myocardial viability test before discharge, for whatever reason Type 1 diabetes Pregnant and / or lactating Age under 18 years or guardianship

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Diagnostic
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Type 2 diabetes group<br>Type 2 diabetes group | Other: Coronary endothelial function measurements by quantitative method (TEP at 15O-H2O)<br> <br> |
| Other: no diabetes<br>no diabetes | Other: Coronary endothelial function measurements by quantitative method (TEP at 15O-H2O)<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Comparison of quantitative variables coronary endothelial function in PET according to the presence or absence of type 2 diabetes in patients investigated with the waning of a first heart attack |  | baseline |