Clinical trial NCT04984915: The Usefulness of CaIMR in Patients With STEMI
Official title: The Long-term Prognostic Value of CaIMR in Patients With ST-segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: CaIMR
Prognosis
ST-segment Elevation Myocardial Infarction
Lead sponsor: Zhongnan Hospital
Sponsor class: OTHER
First posted: 2021-08-02
Enrollment: 400
Sex: ALL
Minimum age (years): 18
Maximum age (years): 80
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: PROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients who meet the inclusion and exclusion criteria are included in the study.

Brief summary: The coronary artery system is composed of three different types of blood vessels, namely epicardial arteries, arterioles and capillaries. Compared with epicardial arteries, arterioles and capillaries are lower than the resolution of current angiography systems, so angiography cannot be used for visualization. Existing studies have shown that coronary microcirculation plays an extremely important role in maintaining full myocardial perfusion. Coronary microvascular disorders can lead to myocardial hypoperfusion and ischemia, and are related to the poor prognosis of patients with coronary heart disease. At present, there is no technology that can directly detect the state of the coronary microcirculation in the human body, but the coronary microcirculation function can be indirectly assessed through two invasive and non-invasive methods. Among them, the index of microcirculation resistance (IMR) is widely used to evaluate coronary microcirculation function \[3\]. However, in the case of epicardial stenosis, accurate determination of IMR requires knowledge of coronary artery contraction pressure (Pw). However, measuring IMR is an invasive examination technique, and measuring IMR requires high technical requirements for the operator. Therefore, the CaIMR value obtained by AI technology can well overcome this limitation, and the existing data show that the CaIMR value has a good correlation with the IMR value. However, CaIMR has a clinical prognosis for patients with acute ST-segment elevation myocardial infarction. The predictive value of CaIMR has not yet been explored. This project aims to evaluate the application value of CaIMR in predicting the occurrence of adverse cardiovascular events in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention.


Eligibility criteria: Inclusion Criteria:

* Patients who are clinically diagnosed with acute ST-segment elevation myocardial infarction and are planned to undergo PCI;
* Volunteer to participate and sign the informed consent

Exclusion Criteria:

* Coronary angiography suggests that it is not suitable for PCI;
* Have performed CABG surgery in the past;
* Lesion of left or right coronary ostium;
* The target vessel is an infarct-related artery (old or acute myocardial infarction recovery period);
* The immediate effect of target vessel PCI is not ideal (such as: final TIMI blood flow \<grade 3, dissection with restricted blood flow, side branch occlusion with diameter\> 1.5 mm, distal embolism or thrombus shown by angiography);
* Severe systemic infection;
* Patients with malignant wasting disease whose estimated survival time is less than 1 year.

Primary outcomes:
measure: The composite endpoint of all-cause death and heart failure rehospitalization
timeFrame: 1 year after surgery
Secondary outcomes:
measure: The composite endpoint of all-cause death and heart failure rehospitalization
timeFrame: 1 month after surgery
measure: All-cause death
timeFrame: 1 year after surgery
measure: All-cause death
timeFrame: 1 month after surgery
measure: Heart failure rehospitalization
timeFrame: 1 year after surgery
measure: Heart failure rehospitalization
timeFrame: 1 month after surgery
measure: Cardiogenic Rehospitalization
timeFrame: 1 year after surgery
measure: Cardiogenic Rehospitalization
timeFrame: 1 month after surgery
Other outcomes:
Locations:
city: Wuhan
country: China
facility: Zhongnan Hospital of Wuhan University
state: Hubei
Study officials:
References: