Diagnostic Ultrasound with contrast agent for non-invasive treatment for Heart Attack

Years funded:
2019

Heart disease is the single leading cause of death in Australia and heart attack (i.e. acute myocardial infarction) is a life-threatening event. It claimed 8,623 Australian lives in 2014 (i.e. 24 deaths/day).


Heart attack requires emergent intervention to restore the blood flow. Fibrinolysis is recommended in Australia, and worldwide, when primary percutaneous coronary intervention (pPCI, so-called “stent” therapy) cannot be performed < 90 min of first medical contact. The fibrinolysis therapy uses a drug injection aiming to restore flow by dissolving the blood clot blocking the heart artery. In Australia, many patients are a long way from a pPCI centre, and these patients usually receive fibrinolysis in hospitals that are not PCI-capable.

Unfortunately, the success rate of fibrinolysis alone is suboptimal, where only 54% are restored to normal flow. This is critically important because 30-day survival among patients with normal flow is twice that of patients with no flow.
Recently, small pilot studies in humans show that a new technique called sonothrombolysis (adding a combination of diagnostic ultrasound with contrast agents to the fibrinolysis) can dissolve the clot at much higher success rate (~ x3) than fibrinolysis only, reduces the heart damage, and improves heart function.

These findings are promising but there has never been a randomised controlled trial (RCT), which is what we propose in this current application. We will perform a pilot RCT to assess the efficacy of this method. If successful, this result will be used to inform the design of a large, multicentre NHMRC clinical trial grant application.

The potential is huge because this method would help many lives who live remote areas or with limited access to a 24/7 PCI centre, as this method could open the heart artery at a much earlier stage. In future, patients can receive this therapy in the ambulance on their way to hospital because this therapy only requires ultrasound and contrast agents.

Researcher Profile

Dr Kazuaki Negishi

Institute: University of Tasmania
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