To investigate the innate pro-inflammatory response in young patients (
ID
Source
Brief title
Condition
- Coronary artery disorders
- Arteriosclerosis, stenosis, vascular insufficiency and necrosis
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
Peripheral blood samples will be drawn for isolation of monocytes and
thrombocytes. The primary endpoint are histone marks of chromatin accessibility
such as H3K4 trimethylation (H3K4me3) and H3K9me2 in the promoter region of
inflammatory cytokines
Secondary outcome
Secondary endpoints are the cytokine release by monocytes in response to
stimulation with Toll-like Receptor(TLR)-agonists and the transformation of
monocytes in foam cells. Also the specific blood platelet function in these
patients will be examined.
Background summary
A number of patients suffers from an acute myocardial infarction (AMI) despite
the absence of the *classical* risk factors for atherosclerosis; we consider
them to be the *unhappy few*. Numerous studies have shown that atherosclerosis
is a chronic inflammatory disease and we hypothesize that these *unhappy few*
have an (epi-)genetic predisposition of an exaggerated innate pro-inflammatory
response, which accelerates the process of atherosclerosis.
Study objective
To investigate the innate pro-inflammatory response in young patients (<50
years of age), who suffered from a myocardial infarction. The pro-inflammatory
response will be examined by the search for immunological and epigenetic
signature characterizing *trained immunity* especially in the monocytes of
peripheral blood, which leads to a more vigorous reaction and to more
production of pro-inflammatory cytokines. At the same time the function of
platelets in peripheral blood will be examined, as platelets form part of the
inflammatory response.
Study design
single-center, observational study
Study burden and risks
In the patients 4 tubes of peripheral blood will be taken prior to and after
one week of statin treatment interruption. Fourteen days of interruption of
statin treatment in stable patients more than 1 year after their myocardial
infarction is not expected to result in worse clinical outcome. Additionally,
fourteen days of aspirin therapy in healthy controls is not expected to result
in adverse clinical outcome.
Geert Grooteplein Zuid 10
Nijmegen 6525GA
NL
Geert Grooteplein Zuid 10
Nijmegen 6525GA
NL
Listed location countries
Age
Inclusion criteria
Cases: 20 patients aged between 18 and 50 year, who presented 1-4 years ago with an acute ST-elevation myocardial infarction without classic cardiovascular risk factors.;controls: 20 healthy controls aged 18 or above. controls will be matched with the cases for age, gender and cardiovascular risk factors.
Exclusion criteria
patients:
- If the index patient has:
o Coagulation disorder
o Diagnosis of vascular disease (e.g. previous myocardial infarction, CVA, etc)
o If the index patient has two or more of the following factors present:Hypertension
o Hypercholesterolemia
o Diabetes mellitus
Active smoking or an active smoking history within the last 10 years;controles:
o Coagulation disorder
o Diagnosis of vascular disease (e.g. previous myocardial infarction, CVA, etc)
o If the index patient has two or more of the following factors present:Hypertension
o Hypercholesterolemia
o Diabetes mellitus
Active smoking or an active smoking history within the last 10 years
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL61543.091.17 |