SVIBOR - Project code: 3-01-492

MINISTRY OF SCIENCE AND TECHNOLOGY

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Project code: 3-01-492

Prognostic parameters and therapy in acute myocardial infarction

Main researcher: MAVRIĆ, ŽARKO (142340)

Assistants

ZAPUTOVIĆ, LUKA (133542)
ŽAGAR, DAVORKA (196162)
MATANA, ANTE (69363)

Type of research: applied
Duration from: 01/01/93. to 12/31/96.

Papers on project (total): 20
Papers on project quoted in Current Contents: 2

Institution name: Medicinski fakultet, Rijeka (62)
Department/Institute: Department of Internal Medicine Division of Cardiology
Address: Braće Branchetta 22
City: 51000 - Rijeka, Croatia

Communication: Phone: 385 (0)51 21-68-99; E-mail: Zarko.Mavric@mamed.medri.hr; Fax: 385 (0)51 21-80-59

Summary: In this study we shall attempt to clarify certain issues related to the prognostic evaluation of patients with acute myocardial infarction, and to the prospect of improving the effects of thrombolytic therapy. We shall prospectively examine the reliability of our own prognostic index, and the possibility of increasing its predictive value by including more reliable indexes of myocardial infarct size, such as the enzymatic infarct size and the echocardiographic indicator of left ventricular function (wall motion index), into the computation of the prognostic index. We shall examine the characteristics and the prognostic significance of the right ventricular myocardial infarction, and the significance of the prolonged QT interval, particularly its arrhythmogenic potential and correlation with the degree of regional dysfunction of the left ventricle. In the part of the study regarding thrombolytic therapy, we shall examine the possibility of further increasing its effectiveness by modifying the adjuvant and postthrombolytic treatment, e.g., the addition of the free radicals inhibitors (N-acetyl cysteine and deferoxamine) to the treatment protocol, with the goal of decreasing the reperfusion myocardial injury.

Keywords: myocardial infarction, prognosis, therapy, prognostic index, right ventricle, QT interval, thrombolysis, reperfusion, free radicals, deferoxamine, N-acetylcysteine

Research goals: Goals: 1. Prospective evaluation of our own prognostic index in predicting cardiogenic shock development and total mortality rate in patients with acute myocardial infarction (AMI). 2. Assessment of the characteristics and prognostic significance of the right ventricular myocardial infarction (RVMI). 3. Evaluation of the significance of the prolonged QT interval in patients with AMI, particularly of its arrhythmogenic potential and its correlation with the degree of regional left ventricular dysfunction. 4. Estimation of the possibilities of further improvement in the effectiveness of thrombolytic therapy in AMI through modification of the adjuvant and postthrombolytic treatment, e.g., the addition of the free radicals inhibitors in the treatment protocol, the ultimate objective being the reduction of the reperfusion myocardial injury. A contribution to the solution of still pending issues in the thrombolytic therapy (optimal application protocol, the patients' age limits, effects of late thrombolysis). Expected results: 1. Acquiring knowledge of factors that influence the outcome of the disease in patients with AMI, which could enable a more selective application of the different diagnostic and treatment procedures in the higher risk patients. The duration of stay in the intensive care units, and of hospitalization in general, could be adapted to the individual patient. 2. Contribution to the solving of certain issues regarding the AMI, which require further studies due to the inconsistency of the existing opinions (prolonged QT interval, RVMI). 3. Possibility of preventing the reperfusion myocardial injury after thrombolytic treatment in AMI, which would increase its effectiveness.

Other information about the project.


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