Essex heart patient is world’s first to help in international trial
A patient who has been involved in research into the treatment of heart attacks is the first in the world to be recruited to a new trial that could help save lives and improve care.
The patient at the Essex Cardiothoracic Centre (CTC), has become the world’s first to take part in a ground-breaking international trial designed to reduce the risk of patients developing heart failure after a heart attack.
Professor Thomas Keeble and his research fellow Dr Haroun Butt, at Mid and South Essex NHS Foundation Trust, who are leading the trial, explained its importance and the positive impact it could have.
Prof Keeble said:
Being part of this trial is hugely important to us at Essex CTC.
One of the major causes of poor outcomes after a heart attack is what we call microvascular obstruction, where tiny blood vessels deeper in the heart muscle can remain blocked.
When we open the blocked artery, there can still be damage in the very smallest vessels deep in the heart muscle - vessels so tiny that a standard angiogram cannot detect them. This obstruction affects at least 50% of patients who have had a heart attack and is associated with an increased risk of heart failure, reduced heart function, or death.
The REVITALISE trial randomly allocates patients who are found to have microvascular obstruction to one of three groups.
It uses a device called the Controlled Flow Infusion (CoFI) catheter, which can both detect microvascular obstruction immediately after the artery-opening procedure and deliver medication directly to the affected area in the same sitting, without the patient needing any additional procedures.
One group is then given a blood-thinning agent (Tirofiban), another a drug that helps open small blood vessels (Adenosine), and the third group undergoes the catheter procedure without medication.
Prof Keeble and the team at Essex CTC aim to recruit one patient a month as part of the larger international study, which will involve around 280 patients across a number of sites in the UK and Europe.
Its aim is to identify which treatment approach best preserves heart muscle function.
Professor Keeble added:
Finding new ways to prevent patients from developing heart failure following a heart attack could save lives and prevent patients from needing further treatment.
For the first time, we have a device that can tell us, during the procedure itself, whether a patient’s smallest heart vessels are still blocked after we’ve opened the main artery. And if they are, we can treat immediately in the same setting.
If we can show this makes a difference, it could change how heart attacks are managed worldwide, reducing the number of patients who go on to develop heart failure and protecting their quality of life for years to come.