SECURE
Research type
Research Study
Full title
Safety of Early discharge Using index microcirculatory Resistance in patients with acute myocardial infarction
IRAS ID
334935
Contact name
Mohammad Alkhalil
Contact email
Sponsor organisation
Newcastle NHS Foundation Trust
Duration of Study in the UK
3 years, 0 months, 4 days
Research summary
Patients presenting with heart attack remain in hospital for 48 hours following their emergency treatment with stents. Recent UK data highlighted the safety of shorter in-hospital stay following heart attacks. Nonetheless, the decision to early discharge patients remains subjective.
Index microcirculatory resistance (IMR) is a well-established wire-based technology and can directly evaluate the status of the injured heart immediately after a heart attack. It was demonstrated to be a reliable tool in predicting in-hospital complications and outperformed guidelines-recommended models in identifying patients who are susceptible to adverse outcomes whilst in hospital. IMR is strongly linked to the amount of clot inside the heart blood vessel. New technologies appear promising in reducing clot volume which could help protecting the injured heart after a heart attack.
The aim of this study is to evaluate the effect of using IMR to guide hospital discharge and its impact on the strength of heart muscle in patients presenting with heart attack. A sub-study of patients who have large clot volume will be randomised, after obtaining verbal consent, into either new clot removal device or conventional treatment. The amount of clot will be assess using an established imaging device; and IMR will be performed at the end of the stenting procedure.
Patients with favourable IMR will be subsequently randomised into early or standard discharge. Patients in the standard discharge will remain in hospital according to local policy. Patients in the early discharge group will be planned for hospital discharge on the following day. Patients with unfavourable IMR will remain in-hospital according to local policy.
The primary endpoint of this study is the strength of heart muscle as assessed on magnetic resonance imaging after three months. For the sub-study, the primary endpoint is the amount of clot inside the heart blood vessel.REC name
South East Scotland REC 01
REC reference
23/SS/0116
Date of REC Opinion
10 Jan 2024
REC opinion
Further Information Favourable Opinion