Clinical trial NCT00845468: Coronary Flow Reserve and Glucometabolic State
Official title: Coronary Flow Velocity Reserve According to Glucometabolic State in Acute Myocardial Infarction; Relation to Ventricular Systolic and Diastolic Function
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Myocardial Infarction
Diabetes Mellitus
Prediabetes
Keywords: coronary flow reserve
diabetes mellitus
acute myocardial infarction
transthoracic echocardiography
Lead sponsor: Medicinsk Forsknings Afdeling
Sponsor class: OTHER
First posted: 2009-02-18
Enrollment: 190
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients suffering from a acute myocardial infarction

Brief summary: Diabetes mellitus is a major risk factor for the development of ischemic heart disease, and patients with diabetes mellitus have a worse outcome following an acute myocardial infarction than non-diabetic patients. Furthermore, abnormal glucose metabolism below the diagnostic threshold of diabetes mellitus is also associated with increased risk of death compared to patients with a normal glucose metabolism. The frequency of abnormal glucose metabolism in acute myocardial infarction is high, and approximately 70% of myocardial infarction patients have diabetes mellitus, newly diagnosed diabetes mellitus or impaired glucose tolerance, leaving only 30% with normal glucose metabolism. The increased mortality among patients with acute myocardial infarction and abnormal glucose metabolism seems mainly related to a higher occurrence of congestive heart failure, suggesting that an abnormal glucose metabolism may play an important role among others in endothelial dysfunction, infarct healing and overall left ventricle function. This raises the question, whether patients with acute myocardial infarction and abnormal glucose metabolism have increased frequency of micro- or macrovascular disease or both.

Coronary flow velocity reserve reflects the patency of the epicardial coronary artery in combination with vasodilator capacity of the microcirculation and may therefore offer a tool for assessment of macro- and microcirculation.

This study will focus on the relation between coronary flow velocity reserve estimated by transthoracal Doppler echocardiography and mortality, risk for heart failure and left ventricle function after acute myocardial infarction stratified according to glycometabolic state


Eligibility criteria: Inclusion Criteria:

1. Newly diagnosed first AMI based on characteristic clinical symptoms and/or electrocardiographic signs of AMI and Troponin T or I or CK-MB over diagnostic limits for AMI
2. Referral for coronary arteriography based on the actual myocardial infarction
3. Written informed consent

Exclusion Criteria:

1. Previous myocardial infarction
2. Asthma bronchiale
3. 2 or/and 3 degree atrio-ventricular block and paced rhythm
4. Mental state that makes the patient unavailable in attending the study
5. Use of dipyridamol
6. Sick Sinus Syndrome

Primary outcomes:
Secondary outcomes:
Other outcomes:
Locations:
city: Svendborg
country: Denmark
facility: Hospital of Fünen Svendborg
Study officials:
affiliation: Medicinsk Forsknings Afdeling
name: Brian B Løgstrup, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Logstrup BB, Hofsten DE, Christophersen TB, Moller JE, Botker HE, Pellikka PA, Egstrup K. Influence of abnormal glucose metabolism on coronary microvascular function after a recent myocardial infarction. JACC Cardiovasc Imaging. 2009 Oct;2(10):1159-66. doi: 10.1016/j.jcmg.2009.06.012.