Our main goal is to create a prospective cohort of 1500 patients with a first large myocardial infarction allowing us, in a second step, to identify susceptibility genes for the progression of patients towards chronic heart failure using a candidate gene/candidate pathway approach. Our main hypothesis is that there is, for a given initial biomechanical stress (duration of the ischemic episode, size of the infarcted area, etc.), a variation in the individual susceptibility to develop left ventricular remodelling and to progress towards heart failure, and that this variation is linked to genetic variants between individuals.
The research program comprises 4 phases: a selection phase at D0-D1, a pre-inclusion and an inclusion phase at D4±2, a visit at M6, and a 5 year follow up phase. Visit at Day 0 - Day 1: * The first 12-lead ECG, to be included in the observation book, is performed. * The first blood sample is taken. Visit at Day 4±2: * The first transthoracic echocardiography is performed in all patients selected. * In the presence of at least 3 akinetic LV segments at the transthoracic echocardiography, the patient is included. * Demographic data, medical and surgical anteriority, detailed circumstances of occurrence of the MI and any other relevant information is obtained during an interview. * The second 12-lead ECG is performed. * The second blood sample is taken. * The first MRI is performed (optional) Visit at 6 months: * The second transthoracic echocardiography is performed. * The third 12-lead ECG is performed. * The third blood sample is taken. * A 24-hour Holter-ECG monitoring is performed (optional) * The second MRI is performed (optional) Five year follow up (phone contact until 7 years after inclusion): Each patient included at day 4±2 will be contacted by phone 1, 2, 3, 4 and 5 years post-MI to obtain information regarding cardiovascular events and hospitalizations. If the patient cannot be contacted directly, we will try to contact a member of his/her family or his/her family physician.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
658
Our main goal is to create a prospective cohort of 1500 patients with a first large myocardial infarction allowing us, in a second step, to identify susceptibility genes for the progression of patients towards chronic heart failure using a candidate gene/candidate pathway approach.
Pr Damien LOGEART
Paris, France
Identification of patients with LV remodeling from those without remodelling
Our main judgement criterion allowing to distinguish patients with LV remodeling from those without remodelling will be an increase in LV end-diastolic volume \> 20% between day 4±2 and month 6 post-MI.
Time frame: at day 4±2, at month 6
Degree of LV remodelling
To evaluate the degree of LV remodelling (including ventricular arrhythmias) 6 months after a first ST-segment elevation myocardial infarction (STEMI) or Q-wave MI at the era of early revascularization.
Time frame: at month 6
Power of the mutations/ polymorphisms, biomarkers and other intermediate phenotypes identified in predicting cardiovascular events
To evaluate the power of the mutations/ polymorphisms, biomarkers and other intermediate phenotypes identified in predicting cardiovascular events (rehospitalizations, reinfarction, occurrence of HF, transplantation, arrhythmias, death) in a 5-year patient follow-up (years 3 to 7).
Time frame: years 3 to 7
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