A Study of Low-dose Intracoronary Thrombolytic Therapy in STEMI (Heart Attack) Patients.
Status:
Recruiting
Trial end date:
2024-12-31
Target enrollment:
Participant gender:
Summary
Heart attacks are caused by a blood clot blocking the blood vessels of the heart, preventing
blood getting to the heart muscle. Opening up the artery with a balloon (angioplasty) and a
small mesh tube (stent) although life saving can cause this clot to break up and get washed
downstream, which can make the heart attack worse. The investigators can measure the amount
of damage caused to the microcirculation by calculating the IMR (Index of Microcirculatory
resistance).
This can be measured by a wire in the coronary artery with a pressure sensor at the tip. If
the IMR is elevated, it is suggestive of extensive microcirculatory damage. A clot dissolving
medicine can be administered in the artery to try and reduce the IMR which can reduce damage
to the heart muscle and improve outcomes.
Impaired microcirculatory perfusion in patients as a result of ST-elevation myocardial
infarction (STEMI) is associated with poor clinical outcomes. This project seeks to identify
patients with impaired microcirculatory perfusion after STEMI and to assess whether acute
improvement in microcirculatory perfusion in these patients by the use of intracoronary
thrombolytic therapy results in improved clinical outcomes.