Epitranscriptomic Blood Biomarkers for Coronary Artery Disease - A Prospective Cohort Study (IHD-EPITRAN)

Launched by HOSPITAL DISTRICT OF HELSINKI AND UUSIMAA · Aug 26, 2020

Keywords

ClinConnect Summary

The IHD-EPITRAN clinical trial is studying new blood markers that could help in the early diagnosis and treatment of ischemic heart disease (IHD), a condition that can lead to serious heart problems like heart attacks and heart failure. Researchers believe that changes in a specific type of RNA in the blood, called epitranscriptome, might reflect the presence and progression of IHD. By comparing blood samples from different groups of patients—those who have experienced a heart attack, those undergoing heart surgery for IHD, patients with aortic valve issues, and healthy individuals without heart disease—the study aims to find useful biomarkers that can improve patient care.

To participate, you may be eligible if you are between 65 and 75 years old and have a confirmed history of IHD, such as heart attacks or chronic symptoms related to heart conditions. The study is open to all genders and aims to enroll individuals who meet specific health criteria, ensuring they do not have other serious health issues that may complicate the study. If you join, you can expect to provide a blood sample, which will be analyzed to identify these potential biomarkers. This research could lead to better ways of diagnosing and managing heart disease, ultimately helping many patients live healthier lives.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• 1. Cohort I, STEMI + PCI:
• • 1. Earlier PCIs and silent infarctions eligible.
• • 2. ECG confirmed STEMI with Troponin I elevation and pressing chest pain.
• • 3. ECG-indicated local damage correlates with recorded dyskinesia in TTE.
• • 4. During acute PCI and angiography, only one clear occlusion.
• • 5. Successful initial coronary artery reperfusion during PCI.
• 2. Cohort II, Chronic IHD + elective CABG:
• • 1. Chronic and either CCS or NYHA II-IV symptoms for at least one month.
• • 2. First and elective operation. Only heart operation to be performed.
• 3. In transthoracic echocardiogram (TTE):
• • No indication of cardiomyopathy other than ischemic.
• • No pathological remodelling (valves, ventricles and atrias).
• • No clear indication of significant heart failure (i.e. LVEF \> 25%)
• 3. Cohort III, elective aortic replacement therapy (AVR) for stenosis:
• • 1. Chronic and either CCS or NYHA II-IV symptoms for at least one month.
• • 2. Operated as an open heart surgery (either prosthetic or biovalves)
• • 3. No signs of IHD in coronary angiography.
• • 4. Both bicuspid and tricuspid valves eligible.
• 4. Cohort IV, IHD-negative healthy controls defined by coronary CT:
• • 1. Computerized tomography angiogram results are categorized as negative for coronary artery disease.
• • 2. No known heart disease.
• Exclusion Criteria:
• • Condition that limits life expectancy.
• • Combination procedures (i.e. CABG+valve).
• • Chronic renal insufficiency (KDIGO scale Pt-GFR \< 45/min).
• • Active inflammatory/infectious process.
• • Known disease affecting either blood or bone marrow.
• • Structural or functional congenital heart disease.
• • Recorded atrial fibrillation.
• • Other comorbidities in poor clinical control (i.e. uncontrolled severe hypertension \>170-180/100 and for diabetes HbA1c \> 60 mmol/l).
• • Insulin treated diabetes.