Using Advanced CT Scans and Blood Markers to Better Understand Heart Damage and Recovery After a Heart Attack

Acute myocardial infarction with ST-segment elevation (STEMI) remains a leading cause of morbidity and mortality worldwide. Although advances in reperfusion therapy have reduced early mortality, many patients later develop adverse ventricular remodeling (AVR), which increases the risk of heart failure and cardiovascular death. Current imaging methods, such as echocardiography and cardiac magnetic resonance (CMR), provide valuable prognostic information but have limitations in availability, cost, and their ability to predict AVR early and individually. Spectral computed tomography (CT) is an emerging imaging technique that can characterize myocardial tissue, quantify infarct size, assess microvascular obstruction, and detect complications, with lower contrast and radiation requirements compared to conventional CT. In parallel, circulating microRNAs (miRNAs) have been identified as stable and non-invasive biomarkers that reflect key biological processes in post-infarction remodeling. Several miRNAs are linked to fibrosis, apoptosis, and ventricular remodeling, suggesting their potential to complement imaging findings in risk prediction. This study proposes a multicenter, prospective cohort of patients with STEMI and reduced left ventricular function to evaluate whether combining spectral CT tissue characterization with serum miRNA profiling can improve early prediction of AVR. The main objective is to generate and validate a multiparametric prognostic model integrating imaging and molecular biomarkers to identify high-risk patients who may benefit from closer monitoring and tailored therapeutic strategies.

NCT Number	NCT07268391
Lead Sponsor	Instituto de Investigación Biomédica de Salamanca Collaborators: Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III
Conditions	Acute Myocardial Infarction (AMI)
Enrollment	95 participants
Start Date	2025-09-15
Primary Completion	2027-01 (estimated)
Study Completion	2028-12 (estimated)
Updated on ClinicalTrials.gov	2026-08-11