Sinergy acute

“Coronary microcirculation status as predictor of left ventricular dysfunction and heart failure in patients with acute myocardial infarction treated with primary PCI”

Principal investigator:

Prof. dr Goran Stanković

Work package coordinators:

Prof. dr Milika Ašanin

Prof. dr Marija Zdravković

Doc. dr Danijela Zamaklar-Trifunović

Doc. dr Marija Polovina

Doc. dr Gordana Krljanac

250 Patients


About project:

Ischemic heart disease is a recognized major cause of chronic heart failure (HF). Although the widespread availability of primary percutaneous coronary intervention (PCI) has resulted in improved outcomes in recent years, patients with incomplete ST-segment resolution, a surrogate of inadequate myocardial reperfusion, are at an increased risk of developing HF. These clinical observations are well aligned with the findings already generated in the early reperfusion era suggesting that up to 50% of patients with ST-elevation myocardial infarction (STEMI) show signs of coronary microvascular impairment, which has been associated with poor left ventricular (LV) function and larger infarct size.

The primary objective of the SINERGY-ACUTE project is to comparatively assess the association of invasive vs. echocardiography-derived vs. cardiac magnetic resonance (CMR)-based indices of coronary microcirculation with left ventricular (LV) dysfunction. The secondary objective is to measure the relative impact of microvascular dysfunction, CMR-based infarct size, and clinical characteristics on the occurrence of chronic HF after STEMI.

In terms of scientific methodology, we plan to include 2000 consecutive STEMI patients treated with primary PCI, of which 100 will undergo multi-modality coronary microcirculation assessment and 600 will be evaluated with CMR.

We expect the results of our project to provide novel data that compare different modalities of coronary microcirculation assessment after STEMI and their capacity to predict LV dysfunction. In addition, we expect to provide a risk-profiling framework for identifying patients at risk of developing HF after STEMI. Furthermore, our project may have a societal, economic, and healthcare impact by providing contemporary data on the incidence and predictors of HF after STEMI, given that cardiovascular diseases constitute a leading cause of death in Serbia.

This research was supported by the Science Fund of the Republic of Serbia
GRANT No: 7558
Project title: SINERGY-ACUTE