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The purpose of this study is to improve the differential diagnosis and clinical outcomes of acute coronary syndrome with non-obstructive coronary arteries, to investigate the relationship between the structural and functional state of the heart and the clinical course of the disease.
The study non randomized, opened, controlled. Approximately in 1 to 14% of cases,among patients with acute myocardial infarction, there are no obstructive changes in the coronary arteries according to invasive coronary angiography (defined as stenosis of >50%, ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation, 2017). Highly sensitive Troponin I is a marker of damage to cardiomyocytes, but it is not underlying mechanism of myocardial damage.
It is planned to study 40 patients with acute coronary syndrome. On admission, they will receive the standard treatment of ACS with and without ST elevation. Within 24 hours they will be performed diagnostic coronary angiography. In case of non stenotic atherosclerosis of coronary artery (normal / stenosis < 50%)the patients are planned for cardiac contrast MRI, which will identify both ischemic and non-ischemic causes of acute coronary syndrome; MSCT with the purpose for assessing the coronary arteries, the structure of the atherosclerotic plaque; scintigraphy of the myocardium to reveal a perfusion defect.
The frequency of carriers of unfavorable factors of hemostasis system and folate-cycle enzymes in relation to the risk of thrombophilia of allelic variants of genes will be studied, their significance in the development of thrombosis in acute myocardial infarction will be assessed, as well as the profile of markers of proinflammatory and anti-inflammatory response, their significance in the development of acute myocardial infarction in patients with non-obstructive coronary atherosclerosis in comparison with the control group. In a 1 year, repeated studies will be conducted to dynamically assess the structural and functional state of the heart.
Acute Coronary Syndrome
MSCT , CMR imaging.
Tomsk, Tomskii Region
Tomsk National Research Medical Center of the Russian Academy of Sciences
Published on BioPortfolio: 2018-07-06T08:02:13-0400
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