Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial
Abstract Background Although the presence of thrombus in patients with ST-elevation myocardial infarction (STEMI) has been linked to adverse outcomes, routine thrombus aspiration has not been proven effective. A potential explanation is that these patients should be risk-stratified. Traditional clin...
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| Format: | Article |
| Language: | English |
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BMC
2020-03-01
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| Series: | BMC Cardiovascular Disorders |
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| Online Access: | http://link.springer.com/article/10.1186/s12872-020-01393-5 |
| _version_ | 1818969600911474688 |
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| author | Efstratios Karagiannidis Nikolaos V. Konstantinidis Georgios Sofidis Evangelia Chatzinikolaou Georgios Sianos |
| author_facet | Efstratios Karagiannidis Nikolaos V. Konstantinidis Georgios Sofidis Evangelia Chatzinikolaou Georgios Sianos |
| author_sort | Efstratios Karagiannidis |
| collection | DOAJ |
| description | Abstract Background Although the presence of thrombus in patients with ST-elevation myocardial infarction (STEMI) has been linked to adverse outcomes, routine thrombus aspiration has not been proven effective. A potential explanation is that these patients should be risk-stratified. Traditional clinical, laboratory and angiographic parameters used in clinical trials have been proven inadequate to classify patients. Aspirated thrombotic material characteristics might be an additional important parameter that has not yet been addressed. In this report, we aim to describe a methodological analysis of thrombus aspirated from coronary arteries during primary PCI using micro-Computed Τomography (micro-CT). These data will be combined with traditional factors to develop a risk-stratification system with high discriminative power for these patients. Methods Eighty-seven patients with STEMI undergoing thrombus aspiration in AHEPA University Hospital, Greece, will be enrolled in the study. The first patient was enrolled in June 2018. After being aspirated, thrombi are preserved in formalin and their volume and density are calculated with micro-CT. Micro-CT allows us to create 3D models of thrombi from a series of x-ray projection images. These models are further analyzed to find the volume and density of extracted thrombi and to assess potential differences in their structure. Association of these variables with clinical parameters and angiographic outcomes will be explored. Discussion QUEST-STEMI is-to our knowledge-the first study of volumetric coronary thrombus assessment by micro-CT. This method could be used in larger, clinically-oriented trials to help stratify patients with thrombus burden according to their risk for adverse outcomes. Trial registration QUEST-STEMI trial ClinicalTrials.gov number: NCT03429608 Date of registration: February 12, 2018. The study was prospectively registered (registered prior to enrollment of the first participant). |
| first_indexed | 2024-12-20T14:23:10Z |
| format | Article |
| id | doaj.art-2e171480f72148ca8b2301b2006a9a26 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-20T14:23:10Z |
| publishDate | 2020-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-2e171480f72148ca8b2301b2006a9a262022-12-21T19:37:52ZengBMCBMC Cardiovascular Disorders1471-22612020-03-012011810.1186/s12872-020-01393-5Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trialEfstratios Karagiannidis0Nikolaos V. Konstantinidis1Georgios Sofidis2Evangelia Chatzinikolaou3Georgios Sianos4First Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiHellenic Centre for Marine Research, Former US Base at GournesFirst Department of Cardiology, AHEPA University Hospital, Aristotle University of ThessalonikiAbstract Background Although the presence of thrombus in patients with ST-elevation myocardial infarction (STEMI) has been linked to adverse outcomes, routine thrombus aspiration has not been proven effective. A potential explanation is that these patients should be risk-stratified. Traditional clinical, laboratory and angiographic parameters used in clinical trials have been proven inadequate to classify patients. Aspirated thrombotic material characteristics might be an additional important parameter that has not yet been addressed. In this report, we aim to describe a methodological analysis of thrombus aspirated from coronary arteries during primary PCI using micro-Computed Τomography (micro-CT). These data will be combined with traditional factors to develop a risk-stratification system with high discriminative power for these patients. Methods Eighty-seven patients with STEMI undergoing thrombus aspiration in AHEPA University Hospital, Greece, will be enrolled in the study. The first patient was enrolled in June 2018. After being aspirated, thrombi are preserved in formalin and their volume and density are calculated with micro-CT. Micro-CT allows us to create 3D models of thrombi from a series of x-ray projection images. These models are further analyzed to find the volume and density of extracted thrombi and to assess potential differences in their structure. Association of these variables with clinical parameters and angiographic outcomes will be explored. Discussion QUEST-STEMI is-to our knowledge-the first study of volumetric coronary thrombus assessment by micro-CT. This method could be used in larger, clinically-oriented trials to help stratify patients with thrombus burden according to their risk for adverse outcomes. Trial registration QUEST-STEMI trial ClinicalTrials.gov number: NCT03429608 Date of registration: February 12, 2018. The study was prospectively registered (registered prior to enrollment of the first participant).http://link.springer.com/article/10.1186/s12872-020-01393-5ThrombusThrombus aspirationMicro-computed tomographyST-elevation myocardial infarctionInterventional cardiology |
| spellingShingle | Efstratios Karagiannidis Nikolaos V. Konstantinidis Georgios Sofidis Evangelia Chatzinikolaou Georgios Sianos Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial BMC Cardiovascular Disorders Thrombus Thrombus aspiration Micro-computed tomography ST-elevation myocardial infarction Interventional cardiology |
| title | Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial |
| title_full | Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial |
| title_fullStr | Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial |
| title_full_unstemmed | Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial |
| title_short | Rationale and design of a prospective, observational study for the QUantitative EStimation of Thrombus burden in patients with ST-Elevation Myocardial Infarction using micro-computed tomography: the QUEST-STEMI trial |
| title_sort | rationale and design of a prospective observational study for the quantitative estimation of thrombus burden in patients with st elevation myocardial infarction using micro computed tomography the quest stemi trial |
| topic | Thrombus Thrombus aspiration Micro-computed tomography ST-elevation myocardial infarction Interventional cardiology |
| url | http://link.springer.com/article/10.1186/s12872-020-01393-5 |
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