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- Ensaio Clínico NCT07824050
Analysis of Life-threatening ARrhythMias After Acute Coronary Syndrome (ALARM-ACS)
Current Relevance of Malignant Cardiac Arrhythmia in Patients Admitted for Acute Coronary Syndrome
Patients admitted with an acute coronary syndrome (ACS) are at increased risk of malignant cardiac arrhythmias (MA), such as sustained ventricular tachycardia and ventricular fibrillation. Therefore, patients with ST-elevation myocardial infarction (STEMI) are continuously monitored for a minimum of 24 hours after onset symptoms. Longer monitoring is advised in patients at intermediate to high risk of cardiac arrhythmias, however this risk stratification is not evidence based. Hospitalization, particularly in STEMI patients, is advised for a minimum of 48-72 hours.
AMI care requires a substantial commitment of bed capacity and staff, resulting in high healthcare costs.
In patients who have undergone acute PCI (such as STEMI patients or NSTEMI patients with persistent symptoms), monitoring is primarily aimed at early recognition of MA and signs of persistent or recurrent ischaemia after the intervention.
In NSTEMI/UAP patients still awaiting invasive treatment, the emphasis lies on detecting increasing ischaemia in the as-yet untreated coronary vessel, as well as identifying arrhythmias that may arise as a result.
The true incidence of MA cannot be precisely established due to heterogeneity in the literature, and moreover varies between patients with ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina pectoris, owing to differences in disease process and care pathway.
A better understanding of the current incidence and risk of MA in patients with ACS may contribute to optimizing the monitoring of this patient group, thereby enabling more efficient use of hospital beds and healthcare staff. This prospective quality registry therefore aims to establish the current incidence of MA in ACS patients and to identify potential predictors of MA, while also taking into account other acute complications such as asystole and pulseless electrical activity (PEA).
Visão geral do estudo
Status
Descrição detalhada
Primary research question:
What is the incidence of malignant arrhythmias (MA, defined as sustained ventricular tachycardia/ventricular fibrillation) during admission in patients with acute coronary syndrome?
Secondary research questions:
What is the incidence of MA during admission in the subgroups:
ST-elevation myocardial infarction (STEMI) Non-ST-elevation myocardial infarction (NSTEMI) Unstable angina pectoris (UAP) What is the temporal relationship of MA occurrence during admission, and can a peak incidence be identified? What are clinical predictors of MA during admission in patients with acute coronary syndrome? How do polymorphic and monomorphic ventricular arrhythmias compare in terms of frequency of occurrence in patients admitted with acute coronary syndrome? What is in-hospital mortality in ACS patients with versus without MA? What is the incidence of asystole and pulseless electrical activity (PEA) during admission in patients with acute coronary syndrome?
Tipo de estudo
Inscrição (Estimado)
Contactos e Locais
Contato de estudo
- Nome: Luuk C Otterspoor, Dr. M.D.
- E-mail: luuk.otterspoor@catharinaziekenhuis.nl
Estude backup de contato
- Nome: Maud E Kortman, M.D.
- Número de telefone: 040 - 239 91 11
- E-mail: maud.kortman@catharinaziekenhuis.nl
Locais de estudo
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North Brabant
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Eindhoven, North Brabant, Holanda, 5623 EJ
- Recrutamento
- Catharina Hospital Eindhoven
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Contato:
- Maud E Kortman, M.D.
- Número de telefone: 040 239 9111
- E-mail: maud.kortman@catharinaziekenhuis.nl
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Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
- Adulto
- Adulto mais velho
Aceita Voluntários Saudáveis
Método de amostragem
População do estudo
Descrição
Inclusion criteria Patients aged 18 years or older with acute coronary syndrome (ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, and unstable angina pectoris) or out-of-hospital cardiac arrest (OHCA) due to ACS, admitted to the emergency cardiac care unit, emergency department, coronary care unit (CCU), intensive care unit (ICU), or cardiology ward.
Exclusion criteria Patients who have indicated that their data may not be used for scientific research or for improving the quality of care.
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
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Patients aged 18 years or older admitted with acute coronary syndrome
Patients aged 18 years or older with acute coronary syndrome (ACS) (ST-elevation myocardial infarction, non-ST-elevation myocardial infarction or unstable angina pectoris) or out-of-hospital cardiac arrest (OHCA) due to ACS, admitted to the emergency cardiac care unit, emergency department, coronary care unit (CCU), intensive care unit (ICU), or cardiology ward.
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O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Occurrence of one (or more) malignant arrhythmia(s) (sustained VT or VF) during admission
Prazo: During admission
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Occurrence of one (or more) malignant arrhythmia(s) (sustained VT or VF) during admission, defined as from the moment of physical hospital admission until discharge. (For OHCA patients, the index arrhythmic event preceding hospital admission is not counted as a malignant arrhythmia event; only events occurring from the moment of physical hospital admission onward are included.) (Events of sustained VT or VF occurring during admission of an ACS patient following cardiac surgery, such as CABG, will not be included.) |
During admission
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Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
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Asystole/PEA
Prazo: During admission
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Secondary outcome: Occurrence of one (or more) asystole and/or pulseless electrical activity (PEA) event(s) during admission, defined as from the moment of physical hospital admission until discharge. (For OHCA patients, the index arrhythmic event preceding hospital admission is not counted as an asystole/PEA event; only events occurring from the moment of physical hospital admission onward are included.) (Events of asystole or PEA occurring during admission of an ACS patient following cardiac surgery, such as CABG, will not be included.) |
During admission
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Colaboradores e Investigadores
Patrocinador
Investigadores
- Investigador principal: Luuk C Otterspoor, Dr. M.D., Catharina Ziekenhuis Eindhoven
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo (Real)
Conclusão Primária (Estimado)
Conclusão do estudo (Estimado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Real)
Atualizações de registro de estudo
Última Atualização Postada (Real)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
Termos MeSH relevantes adicionais
- Doença do Sistema de Condução Cardíaca
- Dor
- Manifestações Neurológicas
- Doenças Vasculares
- Doenças cardiovasculares
- Processos Patológicos
- Doenças cardíacas
- Arritmias Cardíacas
- Infarte
- Necrose
- Isquemia do miocárdio
- Isquemia
- Dor no peito
- Angina Pectoris
- Taquicardia
- Condições Patológicas, Sinais e Sintomas
- Sinais e sintomas
- Infarto do Miocárdio com Elevação do ST
- Infarto do Miocárdio Sem Elevação do ST
- Parada cardíaca
- Infarto do miocárdio
- Taquicardia Ventricular
- Síndrome Coronariana Aguda
- Angina Instável
- Fibrilação ventricular
Outros números de identificação do estudo
- nWMO-2026.062
- project code 24PPS046 (Número de outro subsídio/financiamento: National collaboration: Holland High Tech, Eindhoven University of Technology, Catharina Hospital Eindhoven, Philips)
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Descrição do plano IPD
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