Clinical Research Directory

Multimodality Assessment of Myocardial Reperfusion After Primary Percutaneous Coronary Intervention

This study aims to evaluate myocardial reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Although primary PCI successfully restores blood flow in the blocked coronary artery, some patients continue to have impaired blood flow within the small vessels of the heart muscle, a condition known as microvascular obstruction (MVO). This complication may be associated with greater myocardial injury and poorer clinical outcomes. The study will investigate whether artificial intelligence (AI)-derived electrocardiographic (ECG) features, coronary angiographic parameters, and cardiac magnetic resonance (CMR) findings can provide complementary information about myocardial reperfusion. Patients undergoing primary PCI will be assessed using ECG and angiographic findings, while CMR will be used to evaluate myocardial injury and microvascular obstruction. The main objective is to determine whether combining AI-derived ECG features and angiographic parameters can improve the prediction of CMR-detected microvascular obstruction after primary PCI. The findings may help identify patients at increased risk of impaired myocardial reperfusion and support future risk assessment strategies following STEMI.

Analysis of Life-threatening ARrhythMias After Acute Coronary Syndrome

Patients admitted with an acute coronary syndrome (ACS) are at increased risk of malignant cardiac arrhythmias (MA), such as sustained ventricular tachycardia and ventricular fibrillation. Therefore, patients with ST-elevation myocardial infarction (STEMI) are continuously monitored for a minimum of 24 hours after onset symptoms. Longer monitoring is advised in patients at intermediate to high risk of cardiac arrhythmias, however this risk stratification is not evidence based. Hospitalization, particularly in STEMI patients, is advised for a minimum of 48-72 hours. AMI care requires a substantial commitment of bed capacity and staff, resulting in high healthcare costs. In patients who have undergone acute PCI (such as STEMI patients or NSTEMI patients with persistent symptoms), monitoring is primarily aimed at early recognition of MA and signs of persistent or recurrent ischaemia after the intervention. In NSTEMI/UAP patients still awaiting invasive treatment, the emphasis lies on detecting increasing ischaemia in the as-yet untreated coronary vessel, as well as identifying arrhythmias that may arise as a result. The true incidence of MA cannot be precisely established due to heterogeneity in the literature, and moreover varies between patients with ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina pectoris, owing to differences in disease process and care pathway. A better understanding of the current incidence and risk of MA in patients with ACS may contribute to optimizing the monitoring of this patient group, thereby enabling more efficient use of hospital beds and healthcare staff. This prospective quality registry therefore aims to establish the current incidence of MA in ACS patients and to identify potential predictors of MA, while also taking into account other acute complications such as asystole and pulseless electrical activity (PEA).

Beyond the Mehran Risk Score: Predictive Value of Total Ischemic Time for Contrast-Induced Nephropathy in ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.

Contrast-Induced Nephropathy (CIN) is a serious complication following primary percutaneous coronary intervention (PCI) in patients presenting with acute ST-segment elevation myocardial infarction (STEMI). While the standard Mehran Risk Score uses static baseline clinical and procedural variables, it lacks dynamic parameters reflecting acute myocardial ischemic duration. Total ischemic time-from symptom onset to balloon inflation-drives systemic inflammation, forward cardiac failure, and renal hypoperfusion. This prospective observational validation cohort study aims to evaluate the independent predictive value of Total Ischemic Time for CIN in acute STEMI patients undergoing primary PCI. Additionally, it investigates whether integrating total ischemic duration into the classic Mehran Risk Score enhances discrimination accuracy, net reclassification, and calibration performance for early pre-procedural risk stratification.

Combined Antioxidant Therapy for Acute Myocardial Infarction

The goal of this clinical trial is to learn if a combined antioxidant therapy (CAT) can reduce heart damage caused by the return of blood flow after blocked arteries are reopened in adults with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). It will also learn about the safety of this treatment. The main questions it aims to answer are: 1. Does combined antioxidant therapy lower infarct size, measured by cardiac magnetic resonance imaging (CMR), compared with placebo? 2. Does combined antioxidant therapy improve heart function, blood biomarkers of heart injury, and short-term clinical outcomes? 3. What problems do participants have when receiving the therapy? Researchers will compare CAT to placebo (a look-alike infusion with no active drug) to see if the treatment lowers infarct size after STEMI. Participants will: * Be randomly assigned to receive either CAT or placebo * Receive the study infusion before and during primary PCI, in addition to standard treatment for STEMI * Have blood tests to measure heart injury, oxidative stress, inflammation, and drug levels * Undergo cardiac magnetic resonance imaging about 3 to 7 days after STEMI. * Be followed for clinical outcomes and safety for 30 days.

Clinical Characteristics, Frailty, and Prognostic Predictors in Patients Aged 75 and Older With Acute Coronary Syndrome

This study will evaluate clinical characteristics, frailty, and predictors of prognosis in patients aged 75 years and older who are hospitalized with acute coronary syndrome (ACS). The research includes both a retrospective and a prospective cohort. The aim is to determine whether frailty scores, combined with clinical and laboratory parameters available at admission, can improve risk prediction for complications and mortality compared with standard risk scores (TIMI, GRACE, Syntax). The study will also compare outcomes between patients treated with percutaneous coronary intervention (PCI) and those treated conservatively with medications. Patients will be followed during hospitalization and for six months after discharge. The results are expected to contribute to more personalized treatment strategies for elderly patients with ACS.

LA Strain in Predicting Early Complication in STEMI After PPCI

The goal of this observational study To evaluate the predictive value of left atrial strain for in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing PPCI. The main questions it aims to answer are: Is low parameters of left atrial strain associated early complication ? What is the correlation between LA strain parameters and conventional echocardiographic indices of left ventricular systolic and diastolic function ? Is there more affection to LA strain in certain territory over the others ? What is the correlation between LA strain and LA volume index across infarct territories ? Does LA strain Correlate with TAPSE and PASP to evaluate right-heart interactions ?

Development and Validation of a Cardiac Magnetic Resonance-Based Multimodal Deep Learning Model for Long-Term Outcome Prediction in ST-Segment Elevation Myocardial Infarction

Objective: This study aims to develop and test a novel artificial intelligence-based prediction model. This model will integrate cardiac magnetic resonance imaging and clinical data to predict the long-term risk of major adverse cardiovascular events in patients who have undergone emergency percutaneous coronary intervention for ST-segment elevation myocardial infarction. Description: This study plans to enroll patients with STEMI who have received primary PCI. Approximately one week after the procedure, patients will undergo a cardiac magnetic resonance scan. Concurrently, we will collect patients' basic information, blood test results during treatment, and procedural records. Thereafter, patients will be followed up regularly (every six months) to record the occurrence of any major adverse cardiac events, such as cardiovascular death, recurrent myocardial infarction, hospitalization for heart failure, or unplanned repeat revascularization.All collected data, including clinical data and analyzed cardiac MR images, will be used to construct a multimodal deep learning model. The model will learn to identify features associated with future cardiac problems. The accuracy of the model will be tested and validated in different patient groups. Potential Impact: If successful, this prediction tool could assist physicians in identifying high-risk patients earlier and more accurately, enabling closer monitoring and more timely interventions, ultimately improving the long-term prognosis for these patients.

Bempedoic Acid in PPCI Impact on Clinical Outcome and Inflammatory Markers

Bempedoic acid in PPCI

High-Dose Rosuvastatin Preloading for Enhanced Outcomes in STEMI Patients Undergoing Primary PCI

To compare the efficacy of high dose rosuvastatin preloading vs placebo before primary PCI in terms of MACE at 30 days