Patients who suffered from ST elevation myocardial infarction since 2006, referred to the General Hospital of Vienna and received primary percutaneous coronary intervention.

Age matched healthy individuals who voluntarily participate in the study.

Whole blood draw, DNA isolation, plasma isolation

ST Elevation Myocardial Infarction

Blood draw

SNPs in the DNase 1 Gene Impair Its Activity and Are Increased in a STE-ACS Patient Cohort Compared to Healthy Controls

Single Nucleotide Polymorphisms in the Deoxyribonuclease 1 Gene Impair Its Activity and Are Increased in a ST-elevation Acute Coronary Syndrome Patient Cohort Compared to Healthy Controls

Andreas Mangold

Medical University of Vienna

patients receive 4 grams of IV alpha 1 antitrypsin preoperatively

10 patients will randomely receive placebo

Post Cardiac Surgery Systemic Inflammatory Response

Alpha 1-Antitrypsin

Single Dose Administration of Alpha-1 Anti-Trypsin for the Amelioration of Organ Injury in Patients Undergoing Cardiac Surgery

Single Dose Administration of Alpha-1 Anti-Trypsin for the Amelioration of Organ Injury and Post Operative Bleeding in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass: Double-blind, Placebo-controlled Pilot Study

1. The occurrence and magnitude of systemic inflammatory response and organ dysfunction will be recorded and quantified by laboratory markers. Related laboratory markers will be monitored on a daily basis during the recovery period (in the intensive care unit and at the ward).

Pulmonary function will be evaluated by measured overall mechanical ventilation time, peak inspiratory pressures (PIP), plateau pressures, physiologic dead space and static and dynamic lung compliance. Bronchoalveolar lavage (BAL) will be performed 3 hours after operation (while the patient is anesthetised and intubated) and extracted fluid will be analyzed for inflammatory markers. A-a DO2 calculation [AaDO2 = (713 x FiO2) - (pCO2 / 0.8) - (paO2)] will be measured daily.
Complete pulmonary function test will be performed before and 4 days after the operation. Chest radiographs will be evaluated and quantified by an independent radiologist for the occurrence of atelectasis, pulmonary edema, or pleural changes.

Daily measurements of urine output, serum creatinine levels, creatinine clearance and urinary albumin levels. Acute kidney injury (AKI) markers will be sampled in the ICU.

The degree of insult to the brain will be measured by plasma S-100 proteinlevels. Assessment of damage to the blood-brain barrier (BBB) will be performed by magnetical resonance imaging (MRI) modality

Daily measurements of serum hepatic enzymes levels.

Monitoring of cardiac enzymes levels; need and magnitude of required inotrope treatment; occurrence of low cardiac output syndrome (defined as systolic blood pressure of 90 mmHg or less coupled with central venous pressure (CVP) of 15 mmHg or more) and incidence of cardiac arrhythmias. Transthoracic echocardiography examination will be performed on postoperative day 5 and assessed by an independent cardiologist.

Operative and postoperative blood loss will be monitored as well as daily hemoglobin levels. Daily platelet counts and thromboelastograms will be performed. The distribution of blood products and total administered will be recorded daily. Postoperative CRP levels will be evaluated daily.

Dan Abramov

Soroka University Medical Center

USPIO given 2-4 days post MI Ferumoxytol enhanced MRI

USPIO given 5-7 days post MI Ferumoxytol enhanced MRI

USPIO given 11-21 days post MI Ferumoxytol enhanced MRI

Myocardial Infarction

Inflammation

Ferumoxytol enhanced MRI

Royal Infirmary of Edinburgh

Clinical Research Imaging Centre

IRon Nanoparticle Enhanced MRI in the Assessment of Myocardial infarctioN

ASSESSMENT OF CELLULAR INFLAMMATION FOLLOWING ACUTE MYOCARDIAL INFARCTION Application Of Ultrasmall Superparamagnetic Particles Of Iron Oxide

Marker of USPIO uptake (and inflammation) in each cohort after myocardial infarction.
The USPIO infusion is given at different time-points for each cohort. However only the R2* value on the MRI 24 hours after infusion will constitute the primary end-point

elastase/infarkts

SNPs in the DNase 1 Gene Impair Its Activity and Are Increased in a STE-ACS Patient Cohort Compared to Healthy Controls

Single Dose Administration of Alpha-1 Anti-Trypsin for the Amelioration of Organ Injury in Patients Undergoing Cardiac Surgery

IRon Nanoparticle Enhanced MRI in the Assessment of Myocardial infarctioN

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