Myocardial Infarction Triggers and Onset in Jordan Study 2

Study Overview
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Brief Summary
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A previous study (MINTOR 1) found that 43% of ST elevation myocardial infarction (STEMI) patients in Jordan had a triggering events. Fifteen years later, with changing demographics and in the post covid-19 time, we believe that triggered acute myocardial infarction might have changed in incidence and nature of the triggering events.

Detailed Description
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The onset of acute ST elevation myocardial infarction (STEMI) is a complex interplay of internal circadian factors and external physical and emotional triggers. These interactions may lead to rupture of an often nonocclusive vulnerable atherosclerotic coronary plaque with subsequent formation of an occlusive thrombus. The onset of MI has a distinct pattern, with peak incidence within the first few hours after awakening, on certain days of the week, and in the winter months. Physical and emotional stresses are important triggers of acute cardiovascular events including MI. Triggering events, internal changes, and external factors vary among different geographical, environmental, and ethnic regions. Life-style changes, pharmacotherapy, and psychologic interventions may potentially modify the response to, and protect against the effects of triggering events. MINTOR 1 showed that 43% of 900+ Jordanians with STEMI were exposed to a physical or emotional triggers before the onset of the heart attack. It was also found that Friday was the day of the week that witnessed more MIs that other days of the week and that 55% of MIs occurred in the early morning hours. It is largely unknown if the frequency and types of triggers, onset time of MI, day with peak of MI incidence have changed over time in Jordan with changing population demographics, especially in the post Covid-19 times. These patients will be followed up for 3 years for occurring of incident vascular events.

Official Title
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Myocardial Infarction Triggers and Onset in Jordan Study (MINTOR) 2

Conditions
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Triggers of Acute Myocardial Infarction, Time of Onset of Acute Myocardial Infarction, Long-term Prognosis After Acute Myocardial Infarction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 years and above. Documented acute ST elevation myocardial infarction. Willing to sign an informed consent. Available contact numbers for a 3-year follow up Exclusion Criteria: Unwilling to sign an informed consent.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Triggers of acute myocardial infarction | Exposure to emotional of physical triggering events before the occurrence of the heart attack | From date of study enrollment until the date of a documented exposure to a trigger, up to the time of discharge from the hospital (2-5 days). | 
| Time of onset of acute myocardial infarction | Documenting the time of onset of the chest pain that marks the onset of the myocardial infarction (expressed as day of the week (MONDAY to SUNDAY) and time of the day (00:00 hr to 24:00 hr). | From date of study enrollment until the date of documenting the day and hour of onset of the heart attach, up to the time of discharge from the hospital (2-5 days) | 
| Acute cardiovascular events | Occurrence of death from any cause, myocardial infarction, stroke, heart failure, repeat coronary revascularization (percutaneous or surgical). | From date of study enrollment until the date of occurrence of the first cardiovascular event (described above) up to three years after study enrollment. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute myocardial infarction, Acute ST-segment elevation myocardial infarction, Triggers of acute myocardial infarction, Middle East, Prognosis