Clinical trial NCT05479838: Evaluation of the Predictive Effect of Inflammatory Markers in MI Patients
Official title: Evaluation of the Predictive Effect of Inflammatory Markers in Predicting the Occurrence of Post-PCI Nephrotoxicity in MI Patients Admitted to the Emergency Department.
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Myocardial Infarction
Keywords: Myocardial Infarction
Nephropathy
Inflammation Mediators
Lead sponsor: Abant Izzet Baysal University
Sponsor class: OTHER
First posted: 2022-07-29
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 90
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: OTHER
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: The patients included in the study will be followed up after the percutaneous intervention with routine controls. CIN identification; Renal dysfunction (a 0.3 mg/dl increase in absolute serum creatinine or at least 1.5-fold increase in basal creatinine) within 7 days of intravenous contrast administration and contrast nephropathy as recommended by the Journal of the American College of Cardiology will be defined. Diagnosis, treatment, follow-up and discharge of patients will proceed according to routine medical procedures. In this study, a different procedure related to diagnosis, treatment, follow-up and discharge will not be used.

Brief summary: Acute myocardial infarction (AMI), triggered by myocardial ischemia and reperfusion injury, is a disease with high morbidity and mortality, and there is a tendency for its incidence to increase at younger ages.

One of the most worrisome complications of primary percutaneous surgery is contrast-induced nephropathy, which is associated with increased mortality and morbidity in myocardial infarction after coronary interventions. In many studies, inflammatory markers, which are thought to give an idea about the development of contrast-related nephropathy, have been examined.

The transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) is a master regulator of cytoprotective protein expression driven by antioxidant response agents (AREs) and plays a decisive role in the regulation of oxidative defense and redox homeostasis in cells.

There are studies showing the role of Nrf2 in the pathogenesis of kidney damage in some studies.

Studies on the effect of Nrf2 level on contrast media nephropathy in patients with contrast media nephropathy (CIN) are limited in the literature.

This study also aimed to form a basis for the literature, which is a small number of studies, in later studies.

Detailed description: Acute myocardial infarction (AMI), triggered by myocardial ischemia and reperfusion injury, is a disease with high morbidity and mortality, and there is a tendency for its incidence to increase at younger ages.

One of the most worrisome complications of primary percutaneous surgery is contrast-induced nephropathy and acute renal failure, which is associated with increased mortality and morbidity in myocardial infarction after coronary interventions. In many studies, markers that are thought to give an idea about the development of contrast-associated nephropathy have been examined. Acute renal failure (ARF) refers to a sudden decrease in glomerular tissue. Glomerular filtration rate (GFR) causes creatinine accumulation in the body and decreased urine output for various reasons, causing serious complications. Apart from dysfunction during the acute phase, there is a significant risk for permanent tissue damage. Therefore, kidney function cannot be restored, leading to the development of chronic renal failure (CKD), a sustained decrease in GFR, and increased long-term mortality. Incomplete recovery can also lead to the onset or further deterioration of chronic renal failure. Clinically, apart from hemodialysis treatment, few effective methods can treat the formation and development of ARF. Therefore, there is still an urgent need for new targets or better treatment options to prevent ARF and promote adaptive repair after ARF occurs. To date, the molecular mechanism of ARF is unclear, but there is increasing evidence that ARF is directly related to oxidative stress. In some studies, there are studies showing the role of Transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) in the pathogenesis of kidney damage.

There is an increase in mortality and morbidity rates due to nephrotoxicity after percutaneous intervention after MI. Studies showing that Nrf2 level may have a protective effect in contrast media nephropathy in patients with contrast media nephropathy (CIN) are limited in the literature.

The transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) is a master regulator of cytoprotective protein expression driven by antioxidant response agents (AREs) and plays a decisive role in the regulation of oxidative defense and redox homeostasis in cells. Although there are studies examining the epidemiological, demographic and clinical characteristics of patients in our country, studies on the importance of inflammatory parameters and the mortality and morbidity of Nrf2 levels are not available in our country.

This study aimed to form the basis of the literature, which is a small number of studies, in later studies.

Eligibility criteria: Inclusion Criteria:

* Those diagnosed with STEMI

Exclusion Criteria:

* Under 18 years of age
* With other clinical diagnoses in ED
* Pregnancy
* Acute or chronic kidney failure
* Malignancy
* Active infection
* Rheumatoid Diseases
* If patient want leave study
* Mortality in 28 days

Primary outcomes:
measure: Nuclear factor erythroid 2-related factor 2 levels
timeFrame: 30 minutes
Secondary outcomes:
measure: Troponin
timeFrame: 30 minutes
Other outcomes:
Locations:
city: Bolu
country: Turkey
facility: Bolu Abant Izzet University faculty of Medicine Department of Emercengy Medicine
state: Merkez
Study officials:
affiliation: Abant Izzet Baysal University
name: Mustafa Enes DEMİREL, M.D.
role: PRINCIPAL_INVESTIGATOR
References: