About OxAMI

OxAMI is the Oxford Acute Myocardial Infarction Study. It is a study in patients who present to the John Radcliffe hospital in Oxford for the treatment of heart disease and/or heart attack. We aim to investigate in more detail heart disease in patients admitted for emergency treatment. Patients recruited to OxAMI are assessed using a combination of invasive and non-invasive investigations and followed up for up to 10 years. OxAMI is funded by the NIHR Oxford Biomedical Research Centre.

Read more about Acute Myocardial Infarction on our What is AMI? page.

The importance of our research:

We hope that our research will help us understand:

What causes a heart attack?
How can we better diagnose patients?
How can we determine long-term outcome?
Can we discover targets that could help develop new treatments?

Participating in the OxAMI study

The study aims to recruit 800 patients. From the time of admission to the hospital and after obtaining patients’ consent, we carry out a number of investigations that are additional to the standard care pathway. During the initial coronary angioplasty procedure (see external OUH page for more information about coronary angioplasty), we measure coronary blood flow and pressure by introducing an additional wire into the heart artery. We may use intravascular imaging to take pictures from inside the heart vessels. We also perform an MRI scan of the heart at 24-48 hours after admission. Additionally we collect blood samples at five time points: upon arrival, immediately after the initial procedure and at 6, 24 and 48 hours afterwards. There may also be some additional procedures. Participants are asked to come back for research follow-up visits to monitor their recovery.

Further information about these elements is below.

► Follow-up schedule

Follow-up research is a crucial part of the study. We invite participants to return for further tests 6 months following the initial procedure. During this appointment they are asked to fill in a simple quality of life questionnaire. The appointment also involves giving a blood sample and having a cardiac MRI scan. Thereafter they will be contacted by telephone yearly for the following 10 years. This gives the researchers the opportunity to monitor participants’ recovery after the initial angioplasty treatment.

► Measurement of coronary blood flow

To study the function of the small heart vessels (the coronary microcirculation) we introduce an additional wire into the heart artery to measure the resistance of the blood flow in these small vessels. How well these small heart vessels function is important for predicting how well people will recover from a heart attack. The picture below is of the human heart showing the coronary arteries (arteries supplying the heart muscle) and small branches of arteries draining from them (coronary microcirculation).

Measu Cor Blood flow

► Intravascular imaging

We use special tiny cameras which are guided through the artery to take pictures from the inside. These internal pictures give us a huge amount of information about the diseased artery. Imaging techniques such as IVUS (intravascular ultrasound) allows real-time imaging of coronary blood vessels, whereas OCT (optical coherence tomography) is used to study the characteristics of the coronary plaque.

OCT imaging. In this image we can see how the heart artery looks from inside. We can also see a stent placed inside the artery to keep it open. Towards the end of the movie we can see the plaque inside the artery.

► Cardiac MRI

Magnetic Resonance Imaging of the heart (Cardiac MRI) is used for assessing many aspects of heart muscle function. A cardiac MRI is a safe test that uses magnets, radio waves and a computer to make detailed pictures of your heart and major blood vessels. The scan creates both still and moving pictures of the heart to look at its structure and how it is working. The doctors use these pictures to help them decide the best way to treat people who have heart problems.

This movie shows the structure and the function of your heart, including the blood flow in the main cavity. Every time your heart beats your heart receives blood and squeezes it out in your main vessels and into the body.

► Blood sample collection for Biomarker discovery

We look at how levels of certain “markers” of heart disease change in blood over time. Analysing blood samples taken before and immediately after PCI in both stable and emergency patients may provide new insights into the molecules released during plaque disruption, and the mechanisms that underlie this process.