Ignite Creation Date:
2024-05-06 @ 3:59 PM
Last Modification Date:
2024-10-26 @ 2:01 PM
Study NCT ID:
NCT04835207
Status:
UNKNOWN
Last Update Posted:
2021-04-08
First Post:
2021-04-02
Brief Title:
Metabolic Profile as a Predictor of No-reflow in Diabetic Patients
Sponsor:
El Zahraa Gamal
Organization:
Assiut University
Study Overview
Official Title:
Metabolic Profile as a Predictor of No-reflow in Diabetic Patients Treated With Primary Percutaneous Coronary Intervention PCI
Status:
UNKNOWN
Status Verified Date:
2021-04
Last Known Status:
NOT_YET_RECRUITING
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
to find metabolic factors that correlate with the development of no-reflow phenomenon that may help prevent its occurrence
Detailed Description:
Acute myocardial infarction AMI with its accompanying adverse sequelae is one of the most common causes of morbidity and mortality in the world
Although reperfusion techniques for ST- elevation myocardial infarction STEMI are constantly improving no-reflow can still lead to poor prognosis
At present the exact mechanism of no-reflow remains unclear but clinical and laboratory findings suggest that it is related to the embolism of the capillary bed ischemic injury vascular endothelial dysfunction production of oxygen free radical and other factors
The no-reflow phenomenon is one of complications of poor functional and clinical outcomes for patients with AMI
The no-reflow phenomenon is present in 25 to 30 of patients with AMI underwent successful coronary recanalization as shown by angiography The myocardial no-reflow phenomenon is associated with a reducution of antegrade myocardial blood flow inspite of an open infarct-related artery in patients with STEMI undergoing PCI Importantly no-reflow is known to be related to unfavorable clinical outcome and prognosis The cause of this complex phenomenon is the variable combination of four pathogenetic components distal atherothrombotic embolization ischemic injury reperfusion injury and susceptibility of coronary microcirculation to injury As a consequence appropriate strategies are expected to prevent or treat these components are expected to avoid the no-reflow Coronary reperfusion therapy is widely performed in patients with AMI However in spite of patency of the infarct-related artery there is no guarantee of salvage of myocardium at risk of ischemia The no-reflow phenomenon is found in 30 of patients after thrombolysis or catheter-based PCI for AMI It is important therefore to be able to predict which lesions are high risk for no reflow before beginning PCI
Many of the well-accepted risk factors for no-reflow are similar to other well-accepted cardiovascular risk factors such as hypertension smoking dyslipidemia diabetes and other inflammatory processes As such there are some generally accepted measures associated with a lower incidence of no-reflow following PCI for STEMI For example in patients with diabetes optimal blood sugar control before the procedure can reduce the occurrence of no-reflow
There are numerous recognized risk factors for the development of coronary artery disease CAD one of the best known is the association between blood lipids and CAD Several prospective studies have established that the risk of cardiac morbidity and mortality is directly related to the concentration of plasma cholesterol The most prevalent view is that the increased risk of myocardial infarction associated with elevated plasma cholesterol levels can be adequately explained on the basis of the increase in number and severity of coronary atherosclerotic vascular lesions
Hyperglycemia is associated with The increased mortality in patients with acute myocardial infarction which caused by a larger infarct size a high incidence of congestive heart failure and cardiogenic shock and death after AMI However the underlying mechanisms of these deleterious effects of hyperglycemia are not well understood Uric acid UA is a byproduct the terminal steps of purine catabolism uric acid synthesis is increased under tissue ischemia Therefore elevated uric acid may affect prognosis of AMI A few studies have doucomented that UA is associated with therapeutic results in patients with AMI UA level is appeared to be related to infarct size and hemodynamic derangement Although prompt restoration of myocardial blood flow is very important for patients with AMI high levels of UA are doucoumented to be significantly associated with the presence of slow coronary flow
Although reperfusion techniques for ST- elevation myocardial infarction STEMI are constantly improving no-reflow can still lead to poor prognosis
At present the exact mechanism of no-reflow remains unclear but clinical and laboratory findings suggest that it is related to the embolism of the capillary bed ischemic injury vascular endothelial dysfunction production of oxygen free radical and other factors
The no-reflow phenomenon is one of complications of poor functional and clinical outcomes for patients with AMI
The no-reflow phenomenon is present in 25 to 30 of patients with AMI underwent successful coronary recanalization as shown by angiography The myocardial no-reflow phenomenon is associated with a reducution of antegrade myocardial blood flow inspite of an open infarct-related artery in patients with STEMI undergoing PCI Importantly no-reflow is known to be related to unfavorable clinical outcome and prognosis The cause of this complex phenomenon is the variable combination of four pathogenetic components distal atherothrombotic embolization ischemic injury reperfusion injury and susceptibility of coronary microcirculation to injury As a consequence appropriate strategies are expected to prevent or treat these components are expected to avoid the no-reflow Coronary reperfusion therapy is widely performed in patients with AMI However in spite of patency of the infarct-related artery there is no guarantee of salvage of myocardium at risk of ischemia The no-reflow phenomenon is found in 30 of patients after thrombolysis or catheter-based PCI for AMI It is important therefore to be able to predict which lesions are high risk for no reflow before beginning PCI
Many of the well-accepted risk factors for no-reflow are similar to other well-accepted cardiovascular risk factors such as hypertension smoking dyslipidemia diabetes and other inflammatory processes As such there are some generally accepted measures associated with a lower incidence of no-reflow following PCI for STEMI For example in patients with diabetes optimal blood sugar control before the procedure can reduce the occurrence of no-reflow
There are numerous recognized risk factors for the development of coronary artery disease CAD one of the best known is the association between blood lipids and CAD Several prospective studies have established that the risk of cardiac morbidity and mortality is directly related to the concentration of plasma cholesterol The most prevalent view is that the increased risk of myocardial infarction associated with elevated plasma cholesterol levels can be adequately explained on the basis of the increase in number and severity of coronary atherosclerotic vascular lesions
Hyperglycemia is associated with The increased mortality in patients with acute myocardial infarction which caused by a larger infarct size a high incidence of congestive heart failure and cardiogenic shock and death after AMI However the underlying mechanisms of these deleterious effects of hyperglycemia are not well understood Uric acid UA is a byproduct the terminal steps of purine catabolism uric acid synthesis is increased under tissue ischemia Therefore elevated uric acid may affect prognosis of AMI A few studies have doucomented that UA is associated with therapeutic results in patients with AMI UA level is appeared to be related to infarct size and hemodynamic derangement Although prompt restoration of myocardial blood flow is very important for patients with AMI high levels of UA are doucoumented to be significantly associated with the presence of slow coronary flow
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None