Actively Recruiting
A Study of Low-dose Intracoronary Thrombolytic Therapy in STEMI (Heart Attack) Patients.
Led by University of Sydney · Updated on 2024-09-27
445
Participants Needed
22
Research Sites
272 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
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.
CONDITIONS
Official Title
A Study of Low-dose Intracoronary Thrombolytic Therapy in STEMI (Heart Attack) Patients.
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Adults aged over 18 years with STEMI symptoms starting within 6 hours and ECG confirming STEMI according to NHF guidelines
- Willing and able to follow all study procedures including treatment and visits
- Able to read, understand, and sign the informed consent form
- Received a metallic drug-eluting stent during PCI
- Agree to undergo cardiac MRI at 3-7 days and 6 months after PCI
You will not qualify if you...
- Previous coronary bypass surgery
- Residual artery narrowing of 50% or more in the affected vessel
- Prior heart attack in the target area
- Contraindications to clot-dissolving therapy, including history of stroke, recent brain surgery, bleeding disorders, or severe uncontrolled high blood pressure
- Contraindications to adenosine used for IMR measurement such as certain heart rhythm problems or lung diseases
- Diagnosis of metastatic cancer
- Severe infections or illnesses that would affect safe participation
- Serious medical or psychiatric conditions limiting compliance
- Pregnancy, breastfeeding, or inadequate contraception
- Participation in another investigational study within the last 30 days
- For cardiac MRI group, inability to undergo MRI due to claustrophobia, implants, or poor kidney function
- Use of GpIIb/IIIa drugs before IMR measurement
- Patients who did not have primary PCI due to mild artery blockage or other reasons
AI-Screening
AI-Powered Screening
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Trial Site Locations
Total: 22 locations
1
Bankstown-Lidcombe Hospital
Bankstown, New South Wales, Australia, 2200
Not Yet Recruiting
2
Royal Prince Alfred Hospital
Camperdown, New South Wales, Australia, 2050
Actively Recruiting
3
Concord Repatriation General Hospital
Concord, New South Wales, Australia, 2139
Actively Recruiting
4
Northern Beaches Hospital
Frenchs Forest, New South Wales, Australia, 2086
Not Yet Recruiting
5
Liverpool Hospital
Liverpool, New South Wales, Australia, 2170
Actively Recruiting
6
John Hunter Hospital
New Lambton Heights, New South Wales, Australia, 2305
Actively Recruiting
7
Prince of Wales Hospital
Randwick, New South Wales, Australia, 2031
Not Yet Recruiting
8
Wollongong Hospital
Wollongong, New South Wales, Australia, 2500
Withdrawn
9
Royal Adelaide Hospital
Adelaide, South Australia, Australia, 5000
Actively Recruiting
10
Lyell McEwin Hospital
Elizabeth Vale, South Australia, Australia, 5112
Actively Recruiting
11
Box Hill Hospital
Box Hill, Victoria, Australia, 3128
Actively Recruiting
12
Jessie McPherson Private Hospital
Clayton, Victoria, Australia, 3168
Actively Recruiting
13
Victorian Heart Hospital
Clayton, Victoria, Australia, 3168
Actively Recruiting
14
The Northern Hospital
Epping, Victoria, Australia, 3076
Actively Recruiting
15
Frankston Hospital
Frankston, Victoria, Australia, 3199
Actively Recruiting
16
Sunshine Hospital
Saint Albans, Victoria, Australia, 3021
Actively Recruiting
17
Fiona Stanley Hospital
Murdoch, Western Australia, Australia, 6150
Not Yet Recruiting
18
Royal Perth Hospital
Perth, Western Australia, Australia, 6000
Actively Recruiting
19
Auckland City Hospital
Auckland, New Zealand, 1023
Not Yet Recruiting
20
Christchurch Hospital
Christchurch, New Zealand, 4710
Not Yet Recruiting
21
Waikato Hospital
Hamilton, New Zealand, 3240
Actively Recruiting
22
Wellington Hospital
Wellington, New Zealand, 2820
Not Yet Recruiting
Research Team
M
Martin Ng, MBBS (Hons)
CONTACT
R
Rebecca Mister
CONTACT
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
OTHER
Number of Arms
2
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