Assessing Coronary Non-Culprit Plaque Early with Start of PCSK9 Inhibitors in Acute Myocardial Infarction (ACCESS-AMI)

Launched by YUN DAI CHEN · Feb 25, 2025

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ClinConnect Summary

The ACCESS-AMI clinical trial is investigating whether a medication called PCSK9 inhibitors can help improve heart health in patients who have had a heart attack (also known as acute myocardial infarction or AMI). The study aims to find out if giving these medications either shortly before or after a procedure to open blocked arteries can make the plaque in the arteries more stable and reduce inflammation. Researchers will compare the effects of PCSK9 inhibitors with a combination treatment of statins and ezetimibe, both of which are commonly used to lower cholesterol, to see which approach better prevents further heart problems.

To participate in this trial, individuals must be at least 18 years old and have recently been hospitalized for a heart attack. They should have had a procedure to treat the blocked artery and have at least two other arteries with moderate blockages. Participants will receive either the PCSK9 inhibitors or the combination therapy for a year and will undergo follow-up tests to monitor their heart health. It’s important to note that certain health issues, like severe heart or kidney problems, may exclude someone from participating. This study is set to start in January 2024, and anyone interested should discuss it with their doctor for more information.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. Age ≥18 years old.
• • 2. Admitted to hospital for acute myocardial infarction (STEMI, NSTEMI) and successfully underwent PCI of the infarct vessel.
• • 3. Coronary angiography revealed two non-infarct-related arteries with non-blocking lesions (diameter stenosis of 40-70%).
• • 4. Able to sign informed consent.
• • 5. Willing to undergo 1-year follow-up.
• Exclusion Criteria:
• • 1. Left main artery disease or severe coronary artery calcification;
• • 2. Hemodynamic instability or uncontrolled arrhythmia;
• • 3. History of coronary artery bypass;
• • 4. severe renal insufficiency, active liver disease or liver insufficiency, hematological disease, metabolic or endocrine dysfunction, systemic infection, active malignant tumor and other potentially life-threatening diseases, or the expected survival time is \< 1 year;
• • 5. Received any PCSK9 inhibitor treatment within the previous 3 months;
• • 6. Pregnant or nursing women or women planning pregnancy;
• • 7. The researcher determined that it was not suitable for inclusion in the group.