Clinical trial NCT01000701: Inflammation and Acute Coronary Syndromes
Official title: Inflammation and Acute Coronary Syndromes (ACS) - Novel Strategies for Prevention and Clinical Management
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Acute Coronary Syndromes
Keywords: Inflammation
ACS
Prevention
Education
Clinical management
Lead sponsor: University of Zurich
Sponsor class: OTHER
Collaborators: name: University of Bern
name: University Hospital, Geneva
name: University of Lausanne Hospitals
First posted: 2009-10-23
Enrollment: 4000
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: PROBABILITY_SAMPLE
Study population: Patients presenting with Acute Coronary Syndromes

3 control groups:

* patients with stable coronary artery disease
* healthy controls (blood bank)
* peripheral artery occlusive disease (CLI/ALI)

Brief summary: Subproject 1: Optimize prevention after acute coronary syndromes (ACS) by improving caregiver and patient education (http://elips.hug-ge.ch/eng/index_eng2.htm)

Subproject 2: Discover novel genomic biomarkers of ACS in leukocyte subsets by means of analyzing gene expression profiles and function

Subproject 3: Evaluate novel diagnostic and prognostic biomarkers in soluble form in blood/plasma and urine

Subproject 5: Visualize the vulnerable plaque using intravascular ultrasound/optical coherence tomography (IVUS/OCT) and correlate with outcome and biomarkers

Subproject 7: Characterize the effects of inflammation on progenitor/stem cell-mediated repair after ACS by means of analyzing gene expression profiles and function


Eligibility criteria: Inclusion Criteria:

* All patients with age ≥ 18 years presenting within 5 days (preferably within 72 hours) after pain onset with the main diagnosis of ACS (acute myocardial infarction: STEMI /NSTEMI and threatened infarction: unstable angina pectoris), who enter the hospital: The patients show symptoms, which are compatible with angina pectoris (chest pain, dyspnoea) and at least one of the following characteristics:

  * persistent ST-segment elevation or depression, T inversion or dynamic ECG changes, new left bundle branch block (LBBB)
  * Evidence of positive troponin by local laboratory reference values with a rise and/or fall in serial troponin levels
  * known coronary artery disease, specified as status after myocardial infarction, CABG, or PCI or newly documented ≥50% stenosis of an epicardial coronary artery during the initial catheterization

Exclusion Criteria:

* Severe physical disability,
* Dementia (inability to comprehend study), OR
* Less than 1 year of life expectancy (for non-cardiac reasons).

Primary outcomes:
measure: Major adverse cardiovascular events (MACE) in overall population, defined as composite of cardiac death, myocardial infarction or ischemia-driven revascularization
timeFrame: 30 days and 12 months follow-up
Secondary outcomes:
measure: SP2/SP3/SP5: temporal change in biomarkers (12 months).
timeFrame: SP2/SP3/SP5: 13 months
measure: Correlation with plaque burden and neointimal thickness assessed by IVUS/OCT imaging in ST segment elevation myocardial infarction (STEMI) subgroup (13 months)
timeFrame: 13 months
Other outcomes:
Locations:
city: Bern
country: Switzerland
facility: University Hospital, Bern
city: Geneva
country: Switzerland
facility: University Hospital, Geneva
city: Lausanne
country: Switzerland
facility: University Hospital, Lausanne
city: Zurich
country: Switzerland
facility: University Hospital, Zurich
Study officials:
References:
citation: Gilgien-Denereaz L, Jakob J, Tal K, Gencer B, Carballo D, Raber L, Klingenberg R, Matter CM, Sudano I, Luscher TF, Windecker S, Muller O, Fournier S, Rodondi N, Mach F, Auer R, Nanchen D. Long-term effects of systematic smoking cessation counselling during acute coronary syndrome, a multicentre before-after study. Swiss Med Wkly. 2022 Jul 18;152:w30209. doi: 10.4414/smw.2022.w30209. eCollection 2022 Jul 18.
citation: Kraler S, Wenzl FA, Georgiopoulos G, Obeid S, Liberale L, von Eckardstein A, Muller O, Mach F, Raber L, Losdat S, Schmiady MO, Stellos K, Stamatelopoulos K, Camici GG, Srdic A, Paneni F, Akhmedov A, Luscher TF. Soluble lectin-like oxidized low-density lipoprotein receptor-1 predicts premature death in acute coronary syndromes. Eur Heart J. 2022 May 14;43(19):1849-1860. doi: 10.1093/eurheartj/ehac143.
citation: Kraler S, Wenzl FA, Georgiopoulos G, Obeid S, Liberale L, von Eckardstein A, Muller O, Mach F, Raber L, Losdat S, Schmiady MO, Stellos K, Stamatelopoulos K, Camici GG, Srdic A, Paneni F, Akhmedov A, Luscher TF. Soluble lectin-like oxidized low-density lipoprotein receptor-1 predicts premature death in acute coronary syndromes. Eur Heart J. 2022 Mar 24:ehac143. doi: 10.1093/eurheartj/ehac143. Online ahead of print.
citation: Klingenberg R, Aghlmandi S, Raber L, Akhmedov A, Gencer B, Carballo D, Nanchen D, Bucher HC, Rodondi N, Mach F, Windecker S, Landmesser U, von Eckardstein A, Hamm CW, Luscher TF, Matter CM. Cysteine-Rich Angiogenic Inducer 61 Improves Prognostic Accuracy of GRACE (Global Registry of Acute Coronary Events) 2.0 Risk Score in Patients With Acute Coronary Syndromes. J Am Heart Assoc. 2021 Oct 19;10(20):e020488. doi: 10.1161/JAHA.120.020488. Epub 2021 Oct 8.
citation: Weichwald S, Candreva A, Burkholz R, Klingenberg R, Raber L, Heg D, Manka R, Gencer B, Mach F, Nanchen D, Rodondi N, Windecker S, Laaksonen R, Hazen SL, von Eckardstein A, Ruschitzka F, Luscher TF, Buhmann JM, Matter CM. Improving 1-year mortality prediction in ACS patients using machine learning. Eur Heart J Acute Cardiovasc Care. 2021 Oct 27;10(8):855-865. doi: 10.1093/ehjacc/zuab030.
citation: Rossi VA, Denegri A, Candreva A, Klingenberg R, Obeid S, Raber L, Gencer B, Mach F, Nanchen D, Rodondi N, Heg D, Windecker S, Buhmann J, Ruschitzka F, Luscher TF, Matter CM. Prognostic value of inflammatory biomarkers and GRACE score for cardiac death and acute kidney injury after acute coronary syndromes. Eur Heart J Acute Cardiovasc Care. 2021 May 25;10(4):445-452. doi: 10.1093/ehjacc/zuab003.
citation: Winzap P, Davies A, Klingenberg R, Obeid S, Roffi M, Mach F, Raber L, Windecker S, Templin C, Nietlispach F, Nanchen D, Gencer B, Muller O, Matter CM, von Eckardstein A, Luscher TF. Diabetes and baseline glucose are associated with inflammation, left ventricular function and short- and long-term outcome in acute coronary syndromes: role of the novel biomarker Cyr 61. Cardiovasc Diabetol. 2019 Oct 31;18(1):142. doi: 10.1186/s12933-019-0946-6.
citation: Koskinas KC, Zanchin T, Klingenberg R, Gencer B, Temperli F, Baumbach A, Roffi M, Moschovitis A, Muller O, Tuller D, Stortecky S, Mach F, Luscher TF, Matter CM, Pilgrim T, Heg D, Windecker S, Raber L. Incidence, Predictors, and Clinical Impact of Early Prasugrel Cessation in Patients With ST-Elevation Myocardial Infarction. J Am Heart Assoc. 2018 Apr 13;7(8):e008085. doi: 10.1161/JAHA.117.008085.
citation: Aghlmandi S, Scharer N, Heg D, Raber L, Zwahlen M, Gencer B, Nanchen D, Carballo D, Carballo S, Juni P, von Eckardstein A, Landmesser U, Rodondi N, Mach F, Windecker S, Matter CM, Luscher TF, Klingenberg R. Thrombus aspiration in acute coronary syndromes: prevalence, procedural success, change in serial troponin T levels and clinical outcomes in a contemporary Swiss cohort. Eur Heart J Acute Cardiovasc Care. 2018 Sep;7(6):522-531. doi: 10.1177/2048872617706480. Epub 2017 Apr 20.
citation: Klingenberg R, Aghlmandi S, Raber L, Gencer B, Nanchen D, Heg D, Carballo S, Rodondi N, Mach F, Windecker S, Juni P, von Eckardstein A, Matter CM, Luscher TF. Improved risk stratification of patients with acute coronary syndromes using a combination of hsTnT, NT-proBNP and hsCRP with the GRACE score. Eur Heart J Acute Cardiovasc Care. 2018 Mar;7(2):129-138. doi: 10.1177/2048872616684678. Epub 2016 Dec 28.
citation: Raber L, Klingenberg R, Heg D, Kelbaek H, Roffi M, Tuller D, Baumbach A, Zanchin T, Carballo D, Ostojic M, Stefanini GG, Rodondi N, von Birgelen C, Moschovitis A, Engstrom T, Gencer B, Auer R, Meier B, Mach F, Luscher TF, Juni P, Matter CM, Windecker S; COMFORTABLE and SPUM-ACS Trial Investigators. Safety of Prasugrel Loading Doses in Patients Pre-Loaded With Clopidogrel in the Setting of Primary Percutaneous Coronary Intervention: Results of a Nonrandomized Observational Study. JACC Cardiovasc Interv. 2015 Jul;8(8):1064-1074. doi: 10.1016/j.jcin.2015.03.023.
citation: Reiser H, Klingenberg R, Hof D, Cooksley-Decasper S, Fuchs N, Akhmedov A, Zoller S, Marques-Vidal P, Marti Soler H, Heg D, Landmesser U, Rodondi N, Mach F, Windecker S, Vollenweider P, Matter CM, Luscher TF, von Eckardstein A, Gawinecka J. Circulating FABP4 is a prognostic biomarker in patients with acute coronary syndrome but not in asymptomatic individuals. Arterioscler Thromb Vasc Biol. 2015 Aug;35(8):1872-9. doi: 10.1161/ATVBAHA.115.305365. Epub 2015 Jun 11.
citation: Klingenberg R, Heg D, Raber L, Carballo D, Nanchen D, Gencer B, Auer R, Jaguszewski M, Stahli BE, Jakob P, Templin C, Stefanini GG, Meier B, Vogt P, Roffi M, Maier W, Landmesser U, Rodondi N, Mach F, Windecker S, Juni P, Luscher TF, Matter CM. Safety profile of prasugrel and clopidogrel in patients with acute coronary syndromes in Switzerland. Heart. 2015 Jun;101(11):854-63. doi: 10.1136/heartjnl-2014-306925. Epub 2015 Mar 20.
citation: Auer R, Gencer B, Raber L, Klingenberg R, Carballo S, Carballo D, Nanchen D, Cornuz J, Vader JP, Vogt P, Juni P, Matter CM, Windecker S, Luscher TF, Mach F, Rodondi N. Quality of care after acute coronary syndromes in a prospective cohort with reasons for non-prescription of recommended medications. PLoS One. 2014 Mar 27;9(3):e93147. doi: 10.1371/journal.pone.0093147. eCollection 2014.