Class IV Laser Therapy on Ejection Fraction, Cardio Biomarkers and Functional Outcomes

Study Overview
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Brief Summary
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A total of 60 Individuals with Acute coronary Syndrome who underwent angioplasty with or without stent will be recruited by purposive sampling method in a randomized double-blinded sham controlled trial. Recruited participants will be divided into two group of equal size (n = 30): Sham control group and experimental group by block randomization. The experimental group will subject to Class IV laser therapy along with the standard treatment regime at three spot(s) over the pericardium (left parasternal 2nd, 3rd intercostal space and apex) for a duration of 60 seconds at each point.; immediately after the angioplasty and subsequent two days. Left ventricular ejection fraction will be assessed at base line and after 3 days post-interventions. Cardiac biomarker (Troponin I) will be assessed at base line, peak hours (at 10 hour after revascularization) and on third day post intervention. Function outcomes will be assessed at baseline and at one month follow up.

Detailed Description
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Individuals with acute coronary syndrome admitted in the Cardiac Care Unit of MMIMSR, Mullana, Ambala, Haryana who underwent angioplasty with or without stent during the study period will be screened according to selection criteria. Then the invited participants will be asked to sign a written informed consent for voluntarily participation in the study. Participants will be divided into two group of equal size (n = 30): Sham control group and experimental group by block randomization. The researcher will be divided into therapist and evaluator or assessor. The therapist will responsible for conducting the therapy and evaluator or assessor will responsible for assessment of outcome measures both pre and post intervention. All the assessor or evaluator (lab technicians who assess cardiac biomarkers, Cardiologist who perform echocardiography and assess ECG) will be blinded from the grouping of the participants. The participants will also be blinded to the study by use of laser protected eye wears. Left ventricular ejection fraction, cardiac biomarker (Troponin I) and functional outcomes will be assessed at base line. The experimental group will subject to Class IV laser therapy along with the standard treatment regime at three spot(s) over the pericardium (left parasternal 2nd, 3rd intercostal space and apex) for a duration of 60 seconds at each point.; immediately after the angioplasty and subsequent two days. The sham group will subject to irradiation but the equipment will be kept off. All the outcomes measures will be reassess after 3 days post-interventions.

Official Title
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Class IV Laser Therapy on Ejection Fraction, Cardio Biomarkers and Functional Outcomes Among Individuals With Acute Coronary Syndrome

Conditions
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Acute Coronary Syndrome

Intervention / Treatment
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* Radiation: Class IV Laser
* Radiation: Sham Class IV Laser


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Individuals with Acute Coronary Syndrome (ACS) who underwent angioplasty with drug eluting implant Both male and female above 18 years of age, Hemodynamically stable, Who voluntarily signed the informed consent. Exclusion Criteria: Tumor or growth around mediastinum, Temporary or permanent pacemaker, Receiving steroids or photosensitive drugs, Pregnancy, Epilepsy, LVEF ≤ 30%

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Experimental<br>30 participants will be irradiated with Class IV laser therapy over the left parasternal area to examine the effectiveness of Class IV laser. | Radiation: Class IV Laser<br>* 30 participants will be irradiated with Class IV laser therapy over the left parasternal area to examine the efficacy of class IV laser on ejection fraction, Cardiac Biomarker and functional outcomes. Device: Litecure LCT-1000C Class IV laser will be used in contact method over the left parasternal area in 2nd, 3rd intercostal space and apex. Dosage and Parameters for the irradiation will be calculated. Parameters: 1. Wavelength: 980nm, 2. Power/ Energy density: 6W/6J/cm2 3. Frequency: CW 4. Energy delivered at each spot: 360J 5. irradiation spots: 3 6. Irradiation time: 60 sec at each spot. Both the patient and laser giver will use the laser protected eye wears to ensure standard practice for the laser.<br>|
| Sham Comparator: Sham Controlled<br>30 participants will subject to irradiation but the equipment will be kept off. | Radiation: Sham Class IV Laser<br>* 30 participants in sham control group will be suppose to irradiate with Class IV laser therapy over the left parasternal area, but the radiation will not be delivered. Device: Litecure LCT-1000C Class IV laser will be placed over the left parasternal area in 2nd, 3rd intercostal space and apex without switching on the instrument. Both the patient and laser giver will use the laser protected eye wears to ensure standard practice for the laser.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Left Ventricular Ejection Fraction | Left Ventricular ejection fraction is a is a direct indicator of left ventricle systolic function. | changes will be measured at baseline and on 3rd day post intervention | 
| Cardiac Biomarker | Cardiac Biomarkers (Troponin I) are the early markers of acute myocardial injury | changes will be measured at baseline, peak hours (10 hours post revascularization) and on 3rd day post intervention | 
| Functional outcomes | Hindi version of Seattle angina Questionnaire will be used to assess functional outcomes. | changes will be measured at baseline and on one month follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Class IV Laser, ACS, Ejection fraction, Cardiac Biomarkers