Using Advanced CT Scans and Blood Markers to Better Understand Heart Damage and Recovery After a Heart Attack

Recruiting now · Not applicable

Conditions studied: Acute Myocardial Infarction (AMI)

In brief

Acute myocardial infarction with ST-segment elevation (STEMI) remains a leading cause of morbidity and mortality worldwide. Although advances in reperfusion therapy have reduced early mortality, many patients later develop adverse ventricular remodeling (AVR), which increases the risk of heart failure and cardiovascular death. Current imaging methods, such as echocardiography and cardiac magnetic resonance (CMR), provide valuable prognostic information but have limitations in availability, cost, and their ability to predict AVR early and individually. Spectral computed tomography (CT) is an emerging imaging technique that can characterize myocardial tissue, quantify infarct size, assess microvascular obstruction, and detect complications, with lower contrast and radiation requirements compared to conventional CT. In parallel, circulating microRNAs (miRNAs) have been identified as stable and non-invasive biomarkers that reflect key biological processes in post-infarction remodeling. Several miRNAs are linked to fibrosis, apoptosis, and ventricular remodeling, suggesting their potential to complement imaging findings in risk prediction. This study proposes a multicenter, prospective cohort of patients with STEMI and reduced left ventricular function to evaluate whether combining spectral CT tissue characterization with serum miRNA profiling can improve early prediction of AVR. The main objective is to generate and validate a multiparametric prognostic model integrating imaging and molecular biomarkers to identify high-risk patients who may benefit from closer monitoring and tailored therapeutic strategies.

Key facts

Study ID: NCT07268391
Run by: Instituto de Investigación Biomédica de Salamanca
People needed: 95
Starts: 2025-09-15
Expected to finish: 2028-12-01
Last updated by the study team: 2026-08-05

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

Adults ≥18 years.
First STEMI treated with primary PCI.
Left ventricular ejection fraction (LVEF) ≤45% during index hospitalization.
Ability to provide informed consent.

You may not qualify if…

Contraindication to iodinated contrast media.
Chronic kidney disease with eGFR <30 mL/min/1.73 m².
Prior myocardial infarction or known cardiomyopathy.
Contraindication to CT or MRI imaging.
Life expectancy <1 year due to non-cardiac conditions.

Where it is running

Hospital La Princesa — Madrid, Spain (enrolling)
Hospital Ramón y Cajal — Madrid, Spain (enrolling)
Complejo Asistencial Universitario de Salamanca — Salamanca, Spain (enrolling)
Hospital Clínico Universitario de Valencia — Valencia, Spain (enrolling)
Centro Nacional de Investigaciones Cardiovasculares (CNIC) — Madrid, Spain

Full record on ClinicalTrials.gov

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