A Study of Microcirculatory Function in Type 2 Myocardial Infarction (T2MI)

Mayo Clinic

Status: Begins enrollment in 5 months

Conditions: Coronary Microvascular Disease; Myocardial Infarction

Treatments: Diagnostic Test: Coronary angiogram with coronary reactivity testing (CRT)

Study type: Observational

Funder types: Other

Identifiers

NCT05793567

22-012721

Details and patient eligibility

About

The purpose of this research is to find out if patients with Type 2 Myocardial Infarction (T2MI) without significant epicardial coronary artery disease (CAD) have a greater chance of having coronary microvascular disease (CMD).

Enrollment: 52 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Ability to give informed consent
• Structurally normal heart (normal LV and RV function, no more than mild valvular heart disease)
• For controls: atypical chest pain with indication for CMD testing
• For T2MI: meet criteria for T2MI according to the 4th Universal definition of MI (rise/fall of troponin with at least 1 value >99th centile+ evidence of symptoms or signs of myocardial ischemia)

Exclusion criteria

• Acute coronary event (evidence of plaque rupture, fissure or dissection on coronary angiogram)
• Known to have angiographically significant CAD/pressure wire positive for epicardial CAD
• Inability to receive heparin products
• Allergy/contraindication to acetylcholine/adenosine/nitroglycerine products
• Prior coronary artery bypass grafting
• Pregnancy (if sexually active woman of reproductive age, need negative pregnancy test prior to proceeding with coronary angiography - this is standard of care in cath lab)
• Asthma with prior ICU admission due to bronchospasm/need for invasive ventilation

Trial design

52 participants in 2 patient groups

T2MI Patients

Description:

Patients with T2MI and no epicardial coronary stenosis \>50% will be prospectively enrolled and undergo a routine standard of care coronary angiogram with coronary reactivity testing (CRT).

Treatment:

Diagnostic Test: Coronary angiogram with coronary reactivity testing (CRT)

Controls

Description:

Patients with atypical chest pain and no obstructive disease on coronary angiogram who have been referred for investigation of suspected CMD and have a clinical indication for CMD testing will be retrospectively enrolled and data collected from a previous routine standard of care coronary angiogram with coronary reactivity testing (CRT) will be utilized.