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HighSTEACS Bioresource

Start date:
March 2017
End date:
September 2017
Co-ordinated by:
University of Edinburgh & NHS Lothian
Main trial site:
RIE

Evaluating the kinetics of cardiac biomarkers after ST-segment Elevation myocardial infarction.

Research Team

EMERGE Research team
Cardiology Research Group

Background: Cardiac troponins are integral to the diagnosis of myocardial infarction, and plasma concentrations are used routinely in clinical practice to determine the extent of myocardial injury and to guide prognosis.(1) The latest generation of high-sensitivity assays are now able to measure very low concentrations of cardiac troponin even in healthy individuals, and as such these assay will permit a more accurate evaluation of the release and clearance of cardiac troponins from the circulation following myocardial infarction.(2)

Understanding the kinetics of cardiac biomarker release in patients with myocardial infarction will help clinicians to interpret cardiac troponins in patients who represent with recurrent symptoms, and may help us to identify patients at increased risk of adverse remodelling and subsequent heart failure.

Primary research question

• What factors influence the magnitude and time course of cardiac troponin release and clearance in patients with suspected or confirmed myocardial infarction

Secondary research questions

• Are there differences in troponin release kinetics between patients with ST-segment and Non-ST segment elevation myocardial infarction?
• Does the magnitude and time course of troponin release differ by age and gender?
• How does microvascular obstruction influence the release and clearance of cardiac troponin in patients undergoing percutaneous coronary intervention?
• How does the release and clearance of cardiac troponins compare to other biomarkers of myocardial injury?
• Is peak troponin concentration or a composite measure (area under the curve) a better predictor of left ventricular systolic dysfunction?

Trial Design

Prospective cohort study

Eligibility Criteria (summary)

Patients who present to the Emergency Department with suspected heart disease

Chief Investigator

Dr Nick Mills

Consultant of Cardiology

Local PI

Professor Alasdair Gray

Director of EMERGE & Consultant in Emergency Medicine

Research Team

Rachel O'Brien

Lead Research Nurse

Julia Grahamslaw

Lead Research Nurse

Caroline Blackstock

AMU Senior Research Nurse

Bernadette Gallagher

Senior Research Nurse

Bev Goldberg

AMU Senior Research Nurse

Adam Lloyd

PhD Student & Senior Research Nurse

Allan MacRaild

Senior Research Nurse

Megan McGrath

Senior Research Nurse

Mia Paderanga

Senior Research Nurse

Alison Grant

Senior Research Nurse

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HighSTEACS Bioresource