NCT04448639

Brief Summary

The Stunning in Takotsubo versus Acute Myocardial Infarction (STAMI) Study Background: Acute myocardial stunning, herein defined as the reversible loss of myocardial function, occurs in both takotsubo syndrome (TS) and ST-elevation myocardial infarction (STEMI), and can be life-threatening in both conditions. However, despite typically having considerably more pronounced myocardial stunning, TS patients have better prognosis than patients with STEMI. Despite the different relationship between extent of myocardial stunning and prognosis in TS vs STEMI, no 'head-to-head' comparison of the myocardial stunning phenotypes in TS vs STEMI has been done. Methods: The Stunning In Takotsubo and Acute Myocardial Infarction (STAMI) study is a single-center, prospective clinical study that will enroll 100 patients with STEMI and 25 patients with TS. Echocardiography, laboratory testing (including troponin and NTpro-BNP), and ECG will be done immediately after angiography and at days 1, 2, 3, 7, 14 and 30. The primary endpoint is the proportion of myocardial stunning that has resolved after 72 hours, as determined by echocardiography. Total myocardial stunning is defined as the extent of akinesia observed at day 0 that resolves by day 30.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
125

participants targeted

Target at P50-P75 for all trials

Timeline
56mo left

Started Dec 2019

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress58%
Dec 2019Dec 2030

Study Start

First participant enrolled

December 12, 2019

Completed
6 months until next milestone

First Submitted

Initial submission to the registry

June 3, 2020

Completed
23 days until next milestone

First Posted

Study publicly available on registry

June 26, 2020

Completed
3.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 1, 2024

Completed
6.9 years until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2030

Expected
Last Updated

December 12, 2023

Status Verified

December 1, 2023

Enrollment Period

4.1 years

First QC Date

June 3, 2020

Last Update Submit

December 4, 2023

Conditions

Keywords

Myocardial StunningAcute heart failureTaoktsubo SyndromeAcute myocardial infarction

Outcome Measures

Primary Outcomes (1)

  • Proportion of stunning that has resolved at 3 days versus 14 days

    StunningResolution at 3 days is defined as StunningRes3D = (%Akinesia Baseline - %Akinesia 3day) / (%Akinesia Baseline - %Akinesia 30days); where %Akinesia is calculated as the endocardial length of the akinetic left ventricular myocardium divided by the total endocardial length of the left ventricular myoocardium - as assessed in the apical 2-chamber and 4-chamber views at end-diastole. The recovery of stunning at 3 days is compared to the recovery of stunning at 30 days. Thus a 14 day timeframe is required.

    30 days

Secondary Outcomes (6)

  • Change in wall motion score index

    30 days

  • Change in left ventricular ejection fraction

    30 days

  • Change in global longitudinal strain

    30 days

  • Change in radial strain in the unaffected contralateral myocardial wall

    30 days

  • Change in serum troponin-I:troponin:T ratio

    30 days

  • +1 more secondary outcomes

Study Arms (2)

STEMI

Patients with ST-elevation myocardial Infarction (STEMI) (TS) who undergo urgent coronary angiography within 12 hours of symptom onset.

Diagnostic Test: Echocardigraphy (ECHO)Diagnostic Test: Bloodtest

TS

Patients with Takotsubo Syndrome (TS) who undergo urgent coronary angiography within 12 hours ofsymptom onset.

Diagnostic Test: Echocardigraphy (ECHO)Diagnostic Test: Bloodtest

Interventions

Echocardigraphy (ECHO)DIAGNOSTIC_TEST

Standar 12 lead electrocardiogram

Also known as: Standard electrocardigraphy (ECG )
STEMITS
BloodtestDIAGNOSTIC_TEST

cardiac biomarkers

Also known as: Troponin and NT-proBNP
STEMITS

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)
Sampling MethodNon-Probability Sample
Study Population

Patients with STEMI or TS who undergo urgent coronary angiography within 12 hours of symptom onset.

You may qualify if:

  • STEMI or TS with planned coronary angiography within 12 hours from the onset of symptoms
  • Written consent

You may not qualify if:

  • Cardiogenic shock, defined as Killip class IV
  • Expected inability to comply with the protocol

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of Cardiology; Sahlgrenska University Hospital

Gothenburg, 413 45, Sweden

RECRUITING

Related Publications (1)

  • Jha S, Poller A, Shekka Espinosa A, Molander L, Sevastianova V, Zeijlon R, Simons K, Bobbio E, Pirazzi C, Martinsson A, Mellberg T, Gudmundsson T, Torild P, Sundstrom J, Andersson EA, Thorleifsson S, Salahuddin S, Elmahdy A, Pylova T, Rawshani A, Angeras O, Ramunddal T, Skoglund K, Omerovic E, Redfors B. Prospective comparison of temporal changes in myocardial function in women with Takotsubo versus anterior STEMI. Clin Res Cardiol. 2025 Dec;114(12):1705-1717. doi: 10.1007/s00392-025-02633-4. Epub 2025 Mar 20.

MeSH Terms

Conditions

Myocardial Stunning

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER GOV
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Doctor of medicine, PhD; Associate Proffessor

Study Record Dates

First Submitted

June 3, 2020

First Posted

June 26, 2020

Study Start

December 12, 2019

Primary Completion

January 1, 2024

Study Completion (Estimated)

December 1, 2030

Last Updated

December 12, 2023

Record last verified: 2023-12

Locations