Inflammation in Type 2 Myocardial Infarction

Study Overview
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Brief Summary
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Type 2 myocardial infarction (MI) is defined as myocardial necrosis that results from an imbalance of myocardial oxygen supply and demand. Although type 2 MI is highly prevalent in patients with critical illness and strongly associated with mortality, the pathophysiology remains poorly understood. Inflammation is central to the development of atherosclerosis, plaque rupture, and other subtypes of MI, but the role of inflammation in type 2 MI and myocardial necrosis has not been defined. The investigators aim to to delineate the mechanistic role of inflammation in myocardial necrosis and type 2 MI complicating critical medical illness.

Official Title
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Inflammation in Type 2 Myocardial Infarction

Conditions
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Myocardial Infarction, Inflammation, Critical Illness

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ≥21 years of age admitted to the Medical Intensive or Coronary Care Units sepsis or respiratory failure clinically indicated troponin measurement within 24 hours of ICU admission Exclusion Criteria: unstable angina or Type 1 MI percutaneous or surgical coronary revascularization within 7 days heart failure exacerbation primary valvular disorder aortic dissection infiltrative heart disease or hypertrophic cardiomyopathy myocarditis pulmonary embolism electrocardiogram with >1mm ST segment elevation in two consecutive leads serum cardiac troponin >99th percentile URL but no clear rise or fall pattern history of chronic inflammatory disease use of therapeutic-dose anticoagulants / antiplatelet agents other than aspirin pregnant or incarcerated enrolled in a competing study

Ages Eligible for Study
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Minimum Age: 21 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Critical illness and type 2 MI<br>Critically ill adults with abnormal serum troponin I during hospitalization for critical illness. | |
| Critical illness without type 2 MI<br>Critically ill adults without an elevation in troponin I complicating critical illness. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Leukocyte-platelet aggregates |  | Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Leukocyte-platelet aggregates | Participants will be followed for the duration of hospital stay, an expected average of 10 days. | Day 10 | 
| Monocyte-platelet aggregates |  | Day 1 | 
| Monocyte-platelet aggregates | Participants will be followed for the duration of hospital stay, an expected average of 10 days. | Day 10 | 
| Neutrophil-platelet aggregates |  | Day 1 | 
| Neutrophil-platelet aggregates | Participants will be followed for the duration of hospital stay, an expected average of 10 days. | Day 10 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Myocardial Infarction, Inflammation, Critical Illness, Necrosis, Sepsis, Respiratory Insufficiency, Myocardial Ischemia, Cardiovascular Diseases, Heart Diseases, Vascular Diseases