Plaque Erosion Pilot Study II (PEPSii)
Research type
Research Study
Full title
Plaque Erosion Pilot Study II A single centre, prospective observational pilot study comparing molecular and cellular differences between plaque rupture and plaque erosion in patients with non-ST elevation myocardial infarction undergoing PCI.
IRAS ID
270706
Contact name
Alisdair Ryding
Contact email
Sponsor organisation
Norfolk and Norwich University Hospital
Duration of Study in the UK
1 years, 6 months, 1 days
Research summary
Heart attacks occur when an artery supplying blood to the heart is suddenly blocked by a blood clot. Usually the artery is diseased and narrowed due to a build up of fatty material within the vessel wall (atherosclerosis). About 70% of heart attacks are due to a process called plaque rupture: tissue covering the fatty material thins and suddenly bursts causing a blood clot to form. The processes that cause this are well understood. The other 30% of cases are due to plaque erosion, characterised by the loss of the cells lining the artery (endothelial cells). The processes leading to plaque erosion are poorly understood, but we have previously shown fundamental differences in inflammatory markers between patients with plaque rupture and erosion. One theory is that endothelial cells are attacked by circulating inflammatory cells (neutrophils). In this study we aim to look for direct evidence of this by isolating and characterising endothelial and inflammatory cells from blood samples of heart attack patients. We will also look for differences in cells that repair damaged endothelium. Patients with heart attacks routinely undergo invasive treatment of the narrowed artery with balloons and stents (known as percutaneous coronary intervention: PCI). During this procedure we will use a miniature optical probe in the heart artery (known as Optical Coherence Tomography) to take detailed pictures to determine the underlying cause of the heart attack (erosion or rupture). This technique is widely used to guide PCI procedures, but is not routine. We will also recruit patients under going PCI for stable angina as a control group.
Ultimately a better understanding of plaque erosion will allow better prevention and treatment to be developed.
REC name
East of England - Cambridgeshire and Hertfordshire Research Ethics Committee
REC reference
20/EE/0094
Date of REC Opinion
16 Sep 2020
REC opinion
Further Information Favourable Opinion