Effects of four antiplatelet/statin combined strategies on immune and inflammatory responses in patients with acute myocardial infarction undergoing pharmacoinvasive strategy: Design and rationale of the B and T Types of Lymphocytes Evaluation in Acute Myocardial Infarction (BATTLE-AMI) study: study protocol for a randomized controlled trial

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dc.citation.volume18
dc.contributor.authorFonseca, Francisco A. H. [UNIFESP]
dc.contributor.authorIzar, Maria Cristina [UNIFESP]
dc.contributor.authorMaugeri, Ieda M. L. [UNIFESP]
dc.contributor.authorBerwanger, Otavio
dc.contributor.authorDamiani, Lucas P.
dc.contributor.authorPinto, Ibraim M.
dc.contributor.authorSzarf, Gilberto [UNIFESP]
dc.contributor.authorFranca, Carolina N.
dc.contributor.authorBianco, Henrique T. [UNIFESP]
dc.contributor.authorMoreira, Flavio T. [UNIFESP]
dc.contributor.authorCaixeta, Adriano [UNIFESP]
dc.contributor.authorAlves, Claudia M. R. [UNIFESP]
dc.contributor.authorLopes, Aline Soriano [UNIFESP]
dc.contributor.authorKlassen, Aline [UNIFESP]
dc.contributor.authorTavares, Marina F. M.
dc.contributor.authorFonseca, Henrique A. [UNIFESP]
dc.contributor.authorCarvalho, Antonio C. C. [UNIFESP]
dc.coverageLondon
dc.date.accessioned2020-07-02T18:52:15Z
dc.date.available2020-07-02T18:52:15Z
dc.date.issued2017
dc.description.abstractBackground: Early reperfusion of the occluded coronary artery during acute myocardial infarction is considered crucial for reduction of infarcted mass and recovery of ventricular function. Effective microcirculation and the balance between protective and harmful lymphocytes may have roles in reperfusion injury and may affect final ventricular remodeling. Methods/design: BATTLE-AMI is an open-label, randomized trial comparing the effects of four therapeutic strategies (rosuvastatin/ticagrelor, rosuvastatin/clopidogrel, simvastatin plus ezetimibe/ticagrelor, or simvastatin plus ezetimibe/clopidogrel) on infarcted mass and left ventricular ejection fraction (LVEF) (blinded endpoints) in patients with ST-segment elevation myocardial infarction submitted to fibrinolytic therapy before coronary angiogram (pharmacoinvasive strategy). All patients (n = 300, 75 per arm) will be followed up for six months. The effects of treatment on subsets of B and T lymphocytes will be determined by flow-cytometry/ELISPOT and will be correlated with the infarcted mass, LVEF, and microcirculation perfusion obtained by cardiac magnetic resonance imaging. The primary hypothesis is that the combined rosuvastatin/ticagrelor therapy will be superior to other therapies (particularly for the comparison with simvastatin plus ezetimibe/clopidogrel) for the achievement of better LVEF at 30 days (primary endpoint) and smaller infarcted mass (secondary endpoint) at 30 days and six months. The trial will also evaluate the improvement in the immune/inflammatory responses mediated by B and T lymphocytes. Omics field (metabolomics and proteomics) will help to understand these responses by molecular events. Discussion: BATTLE-AMI is aimed to (1) evaluate the role of subsets of lymphocytes on microcirculation improvement and (2) show how the choice of statin/antiplatelet therapy may affect cardiac remodeling after acute myocardial infarction with ST elevation.en
dc.description.affiliationUniv Fed Sao Paulo, Rua Loefgren 1350, BR-04040001 Sao Paulo, SP, Brazil
dc.description.affiliationHosp Coracao, Rua Desembargador Eliseu Guilherme,147, Sao Paulo, Brazil
dc.description.affiliationInst Dante Pazzanese Cardiol, Ave Dante Pazzanese 500, Sao Paulo, Brazil
dc.description.affiliationUniv Santo Amaro, Rua Prof Eneas de Siqueira 340, Sao Paulo, Brazil
dc.description.affiliationUniv Sao Paulo, Ave Prof Lineu Prestes,748, Sao Paulo, Brazil
dc.description.affiliationUnifespUniv Fed Sao Paulo, Rua Loefgren 1350, BR-04040001 Sao Paulo, SP, Brazil
dc.description.provenanceMade available in DSpace on 2020-07-02T18:52:15Z (GMT). No. of bitstreams: 0 Previous issue date: 2017. Added 1 bitstream(s) on 2020-07-02T20:12:47Z : No. of bitstreams: 1 WOS000418652400002.pdf: 908277 bytes, checksum: df6ab4fe11d29b5bd2c1da961f95f1fb (MD5)en
dc.description.sourceWeb of Science
dc.description.sponsorshipSao Paulo Research Foundation, Sao Paulo, Brazil [FAPESP 2012/51692-7]
dc.description.sponsorshipAstraZeneca [ESR 14-10726]
dc.description.sponsorshipIDFAPESP 2012/51692-7
dc.format.extent-
dc.identifierhttp://dx.doi.org/10.1186/s13063-017-2361-1
dc.identifier.citationTrials. London, v. 18, p. -, 2017.
dc.identifier.doi10.1186/s13063-017-2361-1
dc.identifier.fileWOS000418652400002.pdf
dc.identifier.issn1745-6215
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/53987
dc.identifier.wosWOS:000418652400002
dc.language.isoeng
dc.publisherBiomed Central Ltd
dc.relation.ispartofTrials
dc.rightsAcesso aberto
dc.titleEffects of four antiplatelet/statin combined strategies on immune and inflammatory responses in patients with acute myocardial infarction undergoing pharmacoinvasive strategy: Design and rationale of the B and T Types of Lymphocytes Evaluation in Acute Myocardial Infarction (BATTLE-AMI) study: study protocol for a randomized controlled trialen
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