Landmark clinical trial could change lives
ARU academics carrying out study to cut heart failure risk after a heart attack
Members of the REVITALISE trial team
Cardiac experts at Anglia Ruskin University (ARU) are carrying out a ground-breaking international trial designed to reduce the risk of patients developing heart failure after a heart attack – and have recruited the first global patient.
The patient at the Essex Cardiothoracic Centre (CTC), who has been involved in previous research into the treatment of heart attacks, is the first in the world to be recruited to a new trial, called REVITALISE, that could help save lives and improve care.
Professor Thomas Keeble and his research fellow Dr Haroun Butt of Anglia Ruskin University (ARU), who are leading the trial alongside academics at University of Oxford and University of Glasgow, explained its importance and the positive impact it could have.
“Being part of this trial is hugely important to us at Essex CTC and ARU. 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.”
Professor Thomas KeebleThe 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.
Professor Keeble and the team 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.
“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.”
Professor Thomas Keeble