The Relationship Between MPV,PDW,PFT and ST Segment Resolution in STEMI Patients Treated With Thrombolytic or Primary PCI

NCT ID: NCT03267199

Last Updated: 2023-02-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Study Classification

OBSERVATIONAL

Study Start Date

2020-12-31

Study Completion Date

2021-08-31

Brief Summary

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* The relationship between admission MPV, PDW, platelet function test and ST-segment resolution in STEMI patients treated with either thrombolytic therapy or primary percutaneous coronary intervention
* The relationship between admission MPV, PDW, platelet function test and high thrombus burden \& post-PCI Thrombolysis In Myocardial Infarction (TIMI) flow of infarct related artery in STEMI patients treated with primary percutaneous coronary intervention

Detailed Description

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Reperfusion therapy as the main treatment strategy in patients with ST-segment elevation myocardial infarction (STEMI) consists of either thrombolysis or primary percutaneous coronary intervention (pPCI). Primary percutaneous coronary intervention is the preferred therapy for STEMI; however, cardiac catheterization laboratories may not be widely available.

Early recanalization of the infarct related artery (IRA) by either thrombolytics or percutaneous coronary intervention (PCI) is the main goal in the treatment of acute myocardial infarction. But the eventual aim is to provide reperfusion at the tissue level as well as in the infarct related artery .

Resolution of ST elevation has been shown as an agreeable marker that reflects both epicardial and myocardial reperfusion . In addition, early and complete resolution of ST -segment in the setting of acute myocardial infarction is associated with smaller infarct size, greater ejection fraction and reduced morbidity and mortality .

Platelets play a critical role in the pathogenesis and prognosis of ACS . They secrete a number of substances that are key mediators of coagulation, thrombosis and atherosclerosis. High-volume platelets have a higher thrombotic potential than small platelets and have concentrated granule contents that are of interest in the development of ACS pathogenesis . Mean platelet volume (MPV) is the most commonly used measure of platelet size and correlates with platelet activity. Platelet distribution width (PDW) is an index reflecting heterogeneous platelet size, whereas the platelet-large cell ratio (P-LCR) is the proportion of large platelets in blood circulation. Generally, higher MPV, PDW and P-LCR are correlated with increased platelet size, although they tend to be overlooked in clinical applications. In fact, these indices, particularly MPV and PDW, correlate with platelet functions.

Percutaneous coronary intervention (PCI) is an effective treatment for acute coronary syndrome (ACS), including ST-elevation myocardial infarction (STEMI) and unstable angina. Despite the efficacy of the technique, preprocedural high-thrombus burden (HTB) is a predictor of procedural complications following primary PCI for STEMI. HTB can lead to poor outcomes, including distal embolization, no-reflow, increased myocardial necrosis and decreased left ventricular function.

Although MPV is associated with impaired angiographic reperfusion and poor clinical outcome in patients with STEMI,little is known regarding the association between MPV levels and infarct related artery patency in those patients.

Conditions

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STEMI - ST Elevation Myocardial Infarction

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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patients with high MPV,PDW,PFT

patients with high MPV,PDW,platelet function test

Thrombolytic

Intervention Type DRUG

Thrombolytic therapy

Primary PCI

Intervention Type PROCEDURE

Primary percutaneous coronary intervention

Complete blood count

Intervention Type DIAGNOSTIC_TEST

Blood sample for complete blood count

Platelet function test

Intervention Type DIAGNOSTIC_TEST

Blood sample for platelet function test

ECG

Intervention Type DIAGNOSTIC_TEST

Electrocardiogram

patients with normal or low MPV,PDW, PFT

patients with normal or low MPV,PDW,platelet function test

Thrombolytic

Intervention Type DRUG

Thrombolytic therapy

Primary PCI

Intervention Type PROCEDURE

Primary percutaneous coronary intervention

Complete blood count

Intervention Type DIAGNOSTIC_TEST

Blood sample for complete blood count

Platelet function test

Intervention Type DIAGNOSTIC_TEST

Blood sample for platelet function test

ECG

Intervention Type DIAGNOSTIC_TEST

Electrocardiogram

Interventions

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Thrombolytic

Thrombolytic therapy

Intervention Type DRUG

Primary PCI

Primary percutaneous coronary intervention

Intervention Type PROCEDURE

Complete blood count

Blood sample for complete blood count

Intervention Type DIAGNOSTIC_TEST

Platelet function test

Blood sample for platelet function test

Intervention Type DIAGNOSTIC_TEST

ECG

Electrocardiogram

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* patients with STEMI presented who will be treated with either thrombolytic therapy or primary PCI in assiut university cath lab will be included in the study

Exclusion Criteria

* Patient with complete LBBB on admission ECG
* Active infection
* Documented systemic inflammatory disease
* Malignancy
* End-stage liver
* Renal failure
* Patient receiving oral anticoagulation medicine
* Bleeding diathesis
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Assiut University

OTHER

Sponsor Role lead

Responsible Party

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Nardeen Beshay

resident physician

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

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17100302

Identifier Type: -

Identifier Source: org_study_id

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