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The REDUCE Trial: Restoring microvascular circulation with diagnostic ultrasound and contrast agent

Nepean Blue Mountains Local Health District

  • Translational Research Grants Scheme
Date Funded:
  • 1 July, 2022
Chief Investigator/s:
  • Professor Kazuaki Negishi

Project Summary

Novel additional treatment for heart attacks to salvage heart muscle with ultrasound and contrast agent (REDUCE project).

The main researcher for this project is Professor Kazuaki Negishi.

What is the issue for NSW?

Heart disease is the leading cause of death in NSW. The current standard-of-care for life-threatening heart attack in Australia uses stents to open the large heart arteries blocked with blood clot. However, in half of patients with a successful stent procedure, the clot still blocks micro-vessels causing poorer prognosis. Heart attack patients in rural and remote areas also face longer waits for stenting due to distance, leading to poorer outcomes. To date, no intervention has successfully improved micro-vessel obstruction. As a result, NSW Health continues to face high rates of death and hospital readmission, due to heart failure and the life-threatening heart rhythms suffered by these patients.

What does the research aim to do and how?

The study will test if a novel technique called sonothrombolysis will reduce heart damage by saving more heart muscle in patients with heart attack. Sonothrombolysis uses ultrasound (sono) to break (lysis) micro-vessel clot (thrombo) whilst infusing a contrast agent. We will perform a multicentre, double blind, randomised controlled trial in three NSW hospitals. Patients will be randomised to receive either 1) sonothrombolysis before and after stenting OR 2) sham echo before and after stenting. We will then assess whether sonothrombolysis is better than sham control using advanced cardiac imaging to measure micro vessel obstruction and muscle death.

The project will assess:

  • Reduction in heart muscle death
  • Salvage of more heart muscle
  • Improvement in patient quality of life.