The role of inflammation in myocardial infarction in young patients without risk factors: * the unhappy few* - A pilot study

Recruitment & Eligibility

Status: Completed

Sex: Not specified

Target Recruitment: 80

Inclusion Criteria

Cases:
Twenty patients aged between 18 and 50 year, who present with an acute ST-elevation myocardial infarction eligible for primary percutaneous coronary intervention. ;Family members:
Forty of their first degree healthy family members of the patients presenting with the acute myocardial infarction (two family members per patient).;Controls:
20 healthy controls aged 18 years or above. Controls will be matched with the cases for age, gender and cardiovascular risk factors.

Exclusion Criteria

Cases:
- If the index patient (suffering from the acute myocardial infarction) has one or more of the following factors present:
o Age below 18 years
o Diagnosis of vascular disease (e.g. previous myocardial infarction, CVA, etc)
o Use of statins, anti-inflammatory agents or thrombocyte aggregation inhibitors (these drugs modulate epigenetic changes in in vitro studies)
o Auto-immune diseases (e.g. rheumatoid arthritis)
o Coagulation disorder
o No living first degree family members aged 18 years or above
o Presence of two or more of the following risk factors:
§ Hypertension
§ Hypercholesterolemia
§ Diabetes mellitus
§ Active smoking or an active smoking history within the last 10 years;Family members:
- If the first degree relative (i.e. the participant) has one or more of the following factors present:
o Age below 18 years
o History of vascular disease (e.g. previous myocardial infarction, CVA, etc)
o Use of statins, anti-inflammatory agents or thrombocyte aggregation inhibitors (these drugs modulate epigenetic changes in in vitro studies)
o Signs or symptoms of a current infection (fever, chills)
o Auto-immune diseases (e.g. rheumatoid arthritis)
o Coagulation disorder
Controls:
- If the control has one or more of the following factors present:
o Age below 18 years
o History of vascular disease (e.g. previous myocardial infarction, CVA, etc)
o A first degree family member with vascular disease (e.g. previous myocardial infarction, CVA, etc)
o Family relationship with the cases
o Use of statins, anti-inflammatory agents or thrombocyte aggregation inhibitors (these drugs modulate epigenetic changes in in vitro studies)
o Signs or symptoms of a current infection (fever, chills)
o Auto-immune diseases (e.g. rheumatoid arthritis)
o Coagulation disorder

Study & Design

Study Type: Observational non invasive

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
<p>The primary endpoint is H3K4 trimethylation in the promoter region of<br /><br>inflammatory cytokines and the genetic search for the exonic variant, which can<br /><br>be correlated to the exaggerated pro-inflammatory response. </p><br>

Secondary Outcome Measures

Name	Time	Method
<p>Secondary endpoints are the cytokine release by monocytes in response to<br /><br>stimulation with Toll-like Receptor(TLR)-agonists and the transformation of<br /><br>monocytes in foam cells. Also the specific blood platelet function in these<br /><br>patients will be examined. </p><br>