A myocardial infarction (heart attack) occurs when a blocked coronary artery cuts off blood supply to part of the heart muscle, causing permanent damage if not treated quickly. While emergency care has improved dramatically, preventing second heart attacks and helping the heart recover are still major research focuses.
What's actually going on in research
PCSK9 inhibitors and inclisiran lower LDL cholesterol far below what statins alone can achieve, and trials are testing whether pushing cholesterol to very low levels reduces second heart attacks in survivors. Anti-inflammatory drugs targeting residual inflammatory risk after a heart attack are in large trials following evidence that inflammation — not just cholesterol — drives recurring events. Regenerative approaches including stem cell injections and growth factors are in later-stage trials to see if heart muscle lost to infarction can be partially restored.
Extreme LDL lowering
PCSK9 inhibitors and RNA-interference drugs like inclisiran lower LDL to very low levels. Trials are testing whether this reduces recurrent heart attacks in high-risk survivors.
Anti-inflammatory drugs
Drugs targeting residual inflammatory risk — including colchicine and IL-1 and IL-6 pathway inhibitors — are being tested in heart attack survivors to prevent second events.
Cardiac regeneration
Early-phase trials are injecting stem cells, exosomes, and growth factors into damaged heart muscle to see if they reduce scar size and improve heart pumping function.
What to know before you search
Eligibility depends on time since heart attack, LDL level, inflammatory markers, ejection fraction, and whether prior revascularization was performed.
What types of trials are currently open
- Drug trials — Testing new antiplatelet agents, lipid-lowering drugs, or anti-inflammatories to reduce recurrent heart attacks.
- Intervention trials — Comparing stenting strategies, imaging-guided revascularization, and timing of intervention.
- Cardiac rehabilitation trials — Testing structured exercise, dietary, and psychological programs after heart attack.
- Regenerative trials — Evaluating cell therapies and growth factors to restore heart muscle after infarction.
- Remote monitoring trials — Testing wearable and implantable devices for early detection of heart failure after heart attack.
Recently added Myocardial Infarction trials
TeleheartCR vs. Clinic-Based Cardiac Rehabilitation After Acute Coronary Syndrome
Cardiac rehabilitation (CR) is an effective evidence-based intervention that improves outcomes in patients with acute coronary syndrome (ACS), but many eligible patients do not complete the program. A hybrid CR intervention that combines telehealth, home-based, and clinic-based components (TeleheartCR) may increase participation by addressing barriers to access while maintaining the functional capacity benefits of traditional CR. The purpose of this study is to conduct a randomized controlled trial comparing TeleheartCR with traditional clinic-based CR in patients with ACS to evaluate differences in program adherence and pre-to-post program change in functional capacity.
Coronary and Myocardial Evaluation by Cardiac CT for Acute Myocardial Infarction
Acute myocardial infarction (AMI) remains a major cause of mortality and morbidity worldwide. Although percutaneous coronary intervention (PCI) combined with guideline-directed medical therapy has substantially improved survival, many patients continue to experience adverse cardiovascular events after revascularization, including recurrent ischemic events, heart failure, and malignant arrhythmias. Therefore, accurate risk stratification after PCI is essential for optimizing clinical management and improving long-term outcomes. However, currently available risk prediction tools are limited by suboptimal predictive performance or restricted clinical accessibility. Cardiac imaging plays a central role in post-AMI evaluation. Echocardiography is routinely recommended after PCI to assess cardiac structure and function and to exclude early mechanical complications. Nevertheless, its ability to predict subsequent ventricular remodeling and long-term clinical outcomes is limited. Cardiac magnetic resonance imaging (CMR) is considered the reference standard for myocardial tissue characterization and provides important prognostic markers such as infarct size, microvascular obstruction, and intramyocardial hemorrhage. However, the routine use of CMR in patients with AMI is constrained by limited availability, high cost, and relatively long examination time. In addition, CMR does not directly evaluate coronary artery anatomy or plaque characteristics, which are important determinants of recurrent ischemic events. Recent advances in cardiac computed tomography (CT) have enabled comprehensive assessment of coronary artery disease. Beyond evaluating coronary stenosis, coronary CT angiography can identify high-risk plaque features associated with plaque vulnerability. Furthermore, emerging CT-based techniques allow simultaneous assessment of coronary physiology, perivascular inflammation, myocardial structure and function, and myocardial tissue characteristics. CT-derived fractional flow reserve (CT-FFR) enables noninvasive functional assessment of coronary lesions, while the fat attenuation index (FAI) reflects pericoronary inflammatory activity. In addition, delayed iodine enhancement and dual-energy CT techniques allow evaluation of myocardial injury and fibrosis, and CT-derived extracellular volume fraction (ECV) provides quantitative assessment of myocardial fibrosis. These advances suggest that multimodal cardiac CT may provide an integrated imaging approach for comprehensive risk assessment after AMI. The COMET-AMI study (Coronary and Myocardial Evaluation by Multimodal Cardiac CT in Acute Myocardial Infarction) is a prospective, multicenter cohort study designed to evaluate the prognostic value of multimodal cardiac CT in patients with AMI after PCI. A total of 1,000 patients with AMI undergoing successful PCI will be prospectively enrolled. All participants will undergo multimodal cardiac CT within 7 days after PCI to assess coronary plaque characteristics, coronary physiology, pericoronary adipose tissue inflammation, cardiac structure and function, and myocardial tissue features. A subset of participants will also undergo cardiac magnetic resonance imaging for validation of CT-derived myocardial tissue parameters. Comprehensive clinical information, including demographic characteristics, cardiovascular risk factors, medication history, laboratory biomarkers, and procedural data, will be collected. Quantitative and qualitative analyses of coronary plaques will be performed using dedicated software to assess plaque burden, plaque composition, remodeling characteristics, and high-risk plaque features. Additional CT-derived parameters such as CT-FFR, myocardial strain, pericoronary fat attenuation index, and extracellular volume fraction will also be analyzed. Participants will be followed longitudinally through outpatient visits, telephone interviews, and electronic medical record review for up to five years after PCI. The primary outcomes include composite thrombotic events (cardiac death, recurrent myocardial infarction, and urgent or clinically driven revascularization). Secondary outcomes include heart failure and major arrhythmic events such as new-onset heart failure, sustained ventricular arrhythmia, implantable cardioverter-defibrillator implantation, sudden cardiac death, or resuscitated cardiac arrest. All clinical events will be independently adjudicated by a blinded clinical events committee. Using multimodal cardiac CT-derived imaging biomarkers in combination with clinical and laboratory data, machine learning-based predictive models will be developed to identify key determinants of adverse outcomes after PCI in patients with AMI. The results of this study may provide a novel imaging-based risk stratification strategy and facilitate personalized management for patients with AMI after PCI.
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