Multimodal Biomarkers in Coronary Artery Disease Pathogenesis: The Oxford Acute Myocardial Infarction Study (OXAMI Study)

Coronary artery disease is one of the most common causes of illness and death. It develops when fatty deposits, known as plaques, build up in the arteries that supply blood to the heart. These plaques can gradually narrow the arteries and reduce blood flow, causing symptoms such as chest pain (angina). Sometimes a plaque can suddenly break open, causing a blood clot to form and block the artery. This can lead to a heart attack and permanent damage to the heart muscle. Although much has been learned about coronary artery disease, important questions remain about why some plaques suddenly become unstable, how this affects blood flow through the smallest blood vessels of the heart, and why some patients develop more heart muscle damage than others. The Oxford Acute Myocardial Infarction (OxAMI) research programme aims to improve our understanding of these processes. The investigators will study both the disease within the coronary arteries (the "upstream" problem) and its effects on the heart muscle (the "downstream" damage). By examining these together, the investigators hope to understand more clearly how changes in coronary plaques lead to heart injury and how this differs between patients. Participants undergoing procedures to investigate or treat coronary artery disease provide an important opportunity to study these processes. During coronary angioplasty (also called percutaneous coronary intervention or PCI), a narrow or blocked artery is opened, usually using a small balloon and a stent. This procedure can disturb the underlying plaque in a similar way to the plaque disruption that occurs during a heart attack. Where appropriate, the investigators may therefore collect blood and material released from the plaque during these procedures. Blood may be collected from different locations in the circulation, allowing the investigators to study substances released by the plaque and heart muscle. Material that would otherwise be discarded during treatment may also