<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT04407624</url>
  </required_header>
  <id_info>
    <org_study_id>4923-GOA</org_study_id>
    <nct_id>NCT04407624</nct_id>
  </id_info>
  <brief_title>Effects of Intermittent Exercise Training Programs in Patients With Myocardial Infarction</brief_title>
  <official_title>Effects of Intermittent Exercise Training Programs in Patients With Myocardial Infarction</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Dokuz Eylul University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Dokuz Eylul University</source>
  <oversight_info>
    <has_dmc>Yes</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Cardiovascular diseases are a leading cause of death worldwide. According to the World Health&#xD;
      Organization (WHO), cardiovascular diseases constitute 1/3 of all causes of death.&#xD;
&#xD;
      Myocardial infarction (MI) is an irreversible myocardial necrosis due to prolonged ischemia.&#xD;
&#xD;
      Patients with MI are candidates for cardiac rehabilitation (CR). American Heart Association&#xD;
      (AHA) guidelines recommend exercise-based cardiac rehabilitation and suggest exercise to add&#xD;
      to patients' routine treatment. When the literature on patients with MI is examined, various&#xD;
      exercise programs are seen. The aims of present study is investigating and comparing the&#xD;
      effectiveness of intermittent exercise training and aerobic exercise training programs in&#xD;
      patients with MI.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Cases are divided into two groups as exercise (control) and control group by closed envelope&#xD;
      randomization method. All patients are informed about risk factors and risk factor&#xD;
      management. All patients are trained 3 days in the first week under the supervision of a&#xD;
      physiotherapist to learn individual exercise programs. Exercise programs including warm-up,&#xD;
      loading, cooling, and relaxation exercises are shown. The warm-up period is consist of&#xD;
      light-paced walking, active movements of several large muscle groups. During the loading&#xD;
      period, taking into consideration the heart rate, fatigue and shortness of breath, exercises&#xD;
      such as walking, squat, limb movements with weights, stepping on the steps, walking on&#xD;
      different floors are shown. Stretching exercises are done during the cooling period.&#xD;
      Intermittent loading workouts will consist of 3-minute loads and 1-minute rest intervals.&#xD;
      Moderate aerobic exercise is consist of brisk walking to reach 60-85% of the person's maximum&#xD;
      heart rate. Participants of the experimental group are contacted every two weeks via&#xD;
      communication methods such as e-mail, message and telephone conversation. Exercise diary is&#xD;
      given to all patients and is taken from them at the end of the study.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Unknown status</overall_status>
  <last_known_status>Recruiting</last_known_status>
  <start_date type="Actual">October 9, 2019</start_date>
  <completion_date type="Anticipated">November 12, 2020</completion_date>
  <primary_completion_date type="Anticipated">June 10, 2020</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Change in functional capacity</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Six-minute walk test (6MWT) is a valid, reliable and useful test for assessing functional capacity of patients. This test assesses distance walked over 6 minutes as a sub maximal test of aerobic capacity/endurance.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in peripheral muscle strength</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The Jamar Handgrip Dynamometer is an instrument for measuring the maximum isometric strength of the hand and forearm muscles.&#xD;
Quadriceps isometric muscle strength is measured with a Hand Held Dynamometer.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in respiratory muscle strength</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Measurement of respiratory muscle strength is useful in order to detect respiratory muscle weakness and to quantify its severity. Respiratory muscle strength is assessed by mouth pressures sustained for 1 s during maximal static manoeuvre against a closed shutter.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in FEV1</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>FEV1 is the maximal amount of air which is forcefully exhale in one second. It is then converted to a percentage of normal predicted based on height, weight, and race.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in FVC</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Forced vital capacity (FVC) is the amount of air that can be forcibly exhaled from lungs after taking the deepest breath possible, as measured by spirometry.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in FEV1/FVC</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Also known as Tiffeneau-Pinelli index, FEV1/FVC ratio is often used in diagnosing and treating lung diseases. The FEV1/FVC ratio is a measurement of the amount of air you can forcefully exhale from your lungs.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Change in PEF</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Peak expiratory flow (PEF) is the maximal flow (or speed) achieved during the maximally forced expiration initiated at full inspiration, measured in liters per minute or in liters per second.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Change in weight</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Tanita Body Composition Analyzer determines body weight as kilograms (kg).</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in body mass index</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Tanita Body Composition Analyzer determines Body Mass Index (BMI) which is a simple calculation using a person's height and weight. The formula is BMI = kg/m2 where kg is a person's weight in kilograms and m2 is their height in metres squared.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in body fat percentage</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Tanita Body Composition Analyzer determines the body fat percentage (BFP) which is the total mass of fat divided by total body mass, multiplied by 100.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in lean body mass</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Tanita Body Composition Analyzer determines Lean Body Mass (LBM) also known as &quot;Fat-Free Mass&quot; which is the total weight of body minus all the weight due to your fat mass. LBM includes the weight of organs, skin, bones, body water and muscle mass.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in severity of dyspnoea</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>Modified Medical Research Council (mMRC) dyspnea scale is a valid and reliable test for measuring the severity of dyspnea. This scale ranges from 0 to 4. A higher value represents a worse outcome.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in The Tampa Kinesiophobia Scale for Heart Patients</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The Tampa Kinesiophobia Scale for Heart Patients is a questionnaire consisting of 17 questions evaluating the fear of movement in heart patients. The minimum value is 17 and the maximum value is 68, and the higher score means a worse outcome.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in The International Physical Activity Questionnaire-short form</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The International Physical Activity Questionnaire-short form (IPAQ-SF) consists of 7 questions and gives information about the time spent on walking, moderate-to-severe, severe activities. A score in MET-minutes is obtained. The minimum value is 0 and the higher score means a better outcome.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in The Fatigue Severity Scale</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The Fatigue Severity Scale (FSS) is a 9-item scale which measures the severity of fatigue and its effect on a person's activities and lifestyle in patients with a variety of disorders. The minimum value is 9 and the maximum value is 63. The higher score means greater fatigue severity.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in The Hospital Anxiety and Depression Scale</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The Hospital Anxiety and Depression Scale (HADS) assesses both anxiety and depression, which commonly coexist. It comprises seven questions for anxiety and seven questions for depression, and takes 2-5 min to complete. The minimum value is 0, the maximum value is 21 and the higher score means a worse outcome.</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Change in MacNew Heart Disease Health-Related Quality of Life instrument</measure>
    <time_frame>Baseline, 12th week</time_frame>
    <description>The MacNew Heart Disease Health-related Quality of Life (HRQL) instrument is designed to assess patient's feelings about how ischemic heart disease affects daily functioning and contains 27 items with a global HRQL score and physical limitation and emotional, and social function subscales with a 2-week timeframe. The maximum possible score in any domain is 7 and the minimum is 1. The higher score means a better outcome.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Anticipated">34</enrollment>
  <condition>Myocardial Infarction</condition>
  <arm_group>
    <arm_group_label>Intermittent Exercise Group</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>Warm-up, loading (walking, squat, sitting down on a chair, limb movements with weights, stepping on steps, walking on different floors), cooling and relaxation exercises</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Control Group</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Warm-up, loading (brisk walking at 60-85% of maximum heart rate), cooling and relaxation exercises</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Intermittent Exercise</intervention_name>
    <description>Exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. During the loading period, taking into consideration the heart rate, fatigue and shortness of breath, exercises such as walking, squat, limb movements with weights, stepping on the steps, walking on different floors are shown. Stretching exercises are done during the cooling period. Intermittent loading workouts will consist of 3-minute loads and 1-minute rest intervals. Participants are contacted every two weeks via communication methods such as e-mail, message and telephone conversation. Exercise diary is given to all patients and is taken from them at the end of the study.</description>
    <arm_group_label>Intermittent Exercise Group</arm_group_label>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Control</intervention_name>
    <description>Exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. In loading period, moderate aerobic exercise is consist of brisk walking to reach 60-85% of the person's maximum heart rate. Stretching exercises are done during the cooling period.</description>
    <arm_group_label>Control Group</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Having had MI at least 3 months ago&#xD;
&#xD;
          -  Stable clinical status for at least two weeks&#xD;
&#xD;
          -  Walking independently&#xD;
&#xD;
          -  Volunteer for research study&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Having unstable angina&#xD;
&#xD;
          -  Having uncontrolled hypertension&#xD;
&#xD;
          -  Having hemodynamic instability&#xD;
&#xD;
          -  Participating in any exercise program in the last six months&#xD;
&#xD;
          -  Having a major orthopedic or neurological problem that limits functionality&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>35 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_contact>
    <last_name>Elvan Keleş, PT, MSc</last_name>
    <phone>0902323293535</phone>
    <email>elvan_keles@yahoo.com</email>
  </overall_contact>
  <overall_contact_backup>
    <last_name>Hazal Yakut, PT, MSc</last_name>
    <email>fzthazalyakut@outlook.com</email>
  </overall_contact_backup>
  <location>
    <facility>
      <name>Dokuz Eylül Üniversitesi School of Physical Therapy and Rehabilitation</name>
      <address>
        <city>İzmir</city>
        <zip>35340</zip>
        <country>Turkey</country>
      </address>
    </facility>
    <status>Recruiting</status>
    <contact>
      <last_name>Elvan Keleş, PT, MSc</last_name>
      <phone>00902323293535</phone>
      <email>elvan_keles@yahoo.com</email>
    </contact>
    <investigator>
      <last_name>Hazal Yakut, PT, MSc</last_name>
      <role>Principal Investigator</role>
    </investigator>
    <investigator>
      <last_name>Sevgi Özalevli, PT, PhD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Ahmet Anıl Başkurt, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Hüseyin Dursun, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
    <investigator>
      <last_name>Aylin Özgen Alpaydın, MD</last_name>
      <role>Sub-Investigator</role>
    </investigator>
  </location>
  <location_countries>
    <country>Turkey</country>
  </location_countries>
  <verification_date>May 2020</verification_date>
  <study_first_submitted>January 27, 2020</study_first_submitted>
  <study_first_submitted_qc>May 25, 2020</study_first_submitted_qc>
  <study_first_posted type="Actual">May 29, 2020</study_first_posted>
  <last_update_submitted>May 25, 2020</last_update_submitted>
  <last_update_submitted_qc>May 25, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">May 29, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Dokuz Eylul University</investigator_affiliation>
    <investigator_full_name>Elvan Keles</investigator_full_name>
    <investigator_title>Research Assistant</investigator_title>
  </responsible_party>
  <keyword>Aerobic exercise</keyword>
  <keyword>Intermittent exercise</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Myocardial Infarction</mesh_term>
    <mesh_term>Infarction</mesh_term>
  </condition_browse>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT04407624
org study id: 4923-GOA
nct id: NCT04407624
lead sponsor: 
has dmc: Yes
is fda regulated drug: No
is fda regulated device: No
Cardiovascular diseases are a leading cause of death worldwide. According to the World Health
      Organization (WHO), cardiovascular diseases constitute 1/3 of all causes of death.

      Myocardial infarction (MI) is an irreversible myocardial necrosis due to prolonged ischemia.

      Patients with MI are candidates for cardiac rehabilitation (CR). American Heart Association
      (AHA) guidelines recommend exercise-based cardiac rehabilitation and suggest exercise to add
      to patients' routine treatment. When the literature on patients with MI is examined, various
      exercise programs are seen. The aims of present study is investigating and comparing the
      effectiveness of intermittent exercise training and aerobic exercise training programs in
      patients with MI.
Cases are divided into two groups as exercise (control) and control group by closed envelope
      randomization method. All patients are informed about risk factors and risk factor
      management. All patients are trained 3 days in the first week under the supervision of a
      physiotherapist to learn individual exercise programs. Exercise programs including warm-up,
      loading, cooling, and relaxation exercises are shown. The warm-up period is consist of
      light-paced walking, active movements of several large muscle groups. During the loading
      period, taking into consideration the heart rate, fatigue and shortness of breath, exercises
      such as walking, squat, limb movements with weights, stepping on the steps, walking on
      different floors are shown. Stretching exercises are done during the cooling period.
      Intermittent loading workouts will consist of 3-minute loads and 1-minute rest intervals.
      Moderate aerobic exercise is consist of brisk walking to reach 60-85% of the person's maximum
      heart rate. Participants of the experimental group are contacted every two weeks via
      communication methods such as e-mail, message and telephone conversation. Exercise diary is
      given to all patients and is taken from them at the end of the study.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
measure: Change in functional capacity
time frame: Baseline, 12th week
description: Six-minute walk test (6MWT) is a valid, reliable and useful test for assessing functional capacity of patients. This test assesses distance walked over 6 minutes as a sub maximal test of aerobic capacity/endurance.
measure: Change in peripheral muscle strength
time frame: Baseline, 12th week
description: The Jamar Handgrip Dynamometer is an instrument for measuring the maximum isometric strength of the hand and forearm muscles.
Quadriceps isometric muscle strength is measured with a Hand Held Dynamometer.
measure: Change in respiratory muscle strength
time frame: Baseline, 12th week
description: Measurement of respiratory muscle strength is useful in order to detect respiratory muscle weakness and to quantify its severity. Respiratory muscle strength is assessed by mouth pressures sustained for 1 s during maximal static manoeuvre against a closed shutter.
measure: Change in FEV1
time frame: Baseline, 12th week
description: FEV1 is the maximal amount of air which is forcefully exhale in one second. It is then converted to a percentage of normal predicted based on height, weight, and race.
measure: Change in FVC
time frame: Baseline, 12th week
description: Forced vital capacity (FVC) is the amount of air that can be forcibly exhaled from lungs after taking the deepest breath possible, as measured by spirometry.
measure: Change in FEV1/FVC
time frame: Baseline, 12th week
description: Also known as Tiffeneau-Pinelli index, FEV1/FVC ratio is often used in diagnosing and treating lung diseases. The FEV1/FVC ratio is a measurement of the amount of air you can forcefully exhale from your lungs.
measure: Change in PEF
time frame: Baseline, 12th week
description: Peak expiratory flow (PEF) is the maximal flow (or speed) achieved during the maximally forced expiration initiated at full inspiration, measured in liters per minute or in liters per second.
measure: Change in weight
time frame: Baseline, 12th week
description: Tanita Body Composition Analyzer determines body weight as kilograms (kg).
measure: Change in body mass index
time frame: Baseline, 12th week
description: Tanita Body Composition Analyzer determines Body Mass Index (BMI) which is a simple calculation using a person's height and weight. The formula is BMI = kg/m2 where kg is a person's weight in kilograms and m2 is their height in metres squared.
measure: Change in body fat percentage
time frame: Baseline, 12th week
description: Tanita Body Composition Analyzer determines the body fat percentage (BFP) which is the total mass of fat divided by total body mass, multiplied by 100.
measure: Change in lean body mass
time frame: Baseline, 12th week
description: Tanita Body Composition Analyzer determines Lean Body Mass (LBM) also known as "Fat-Free Mass" which is the total weight of body minus all the weight due to your fat mass. LBM includes the weight of organs, skin, bones, body water and muscle mass.
measure: Change in severity of dyspnoea
time frame: Baseline, 12th week
description: Modified Medical Research Council (mMRC) dyspnea scale is a valid and reliable test for measuring the severity of dyspnea. This scale ranges from 0 to 4. A higher value represents a worse outcome.
measure: Change in The Tampa Kinesiophobia Scale for Heart Patients
time frame: Baseline, 12th week
description: The Tampa Kinesiophobia Scale for Heart Patients is a questionnaire consisting of 17 questions evaluating the fear of movement in heart patients. The minimum value is 17 and the maximum value is 68, and the higher score means a worse outcome.
measure: Change in The International Physical Activity Questionnaire-short form
time frame: Baseline, 12th week
description: The International Physical Activity Questionnaire-short form (IPAQ-SF) consists of 7 questions and gives information about the time spent on walking, moderate-to-severe, severe activities. A score in MET-minutes is obtained. The minimum value is 0 and the higher score means a better outcome.
measure: Change in The Fatigue Severity Scale
time frame: Baseline, 12th week
description: The Fatigue Severity Scale (FSS) is a 9-item scale which measures the severity of fatigue and its effect on a person's activities and lifestyle in patients with a variety of disorders. The minimum value is 9 and the maximum value is 63. The higher score means greater fatigue severity.
measure: Change in The Hospital Anxiety and Depression Scale
time frame: Baseline, 12th week
description: The Hospital Anxiety and Depression Scale (HADS) assesses both anxiety and depression, which commonly coexist. It comprises seven questions for anxiety and seven questions for depression, and takes 2-5 min to complete. The minimum value is 0, the maximum value is 21 and the higher score means a worse outcome.
measure: Change in MacNew Heart Disease Health-Related Quality of Life instrument
time frame: Baseline, 12th week
description: The MacNew Heart Disease Health-related Quality of Life (HRQL) instrument is designed to assess patient's feelings about how ischemic heart disease affects daily functioning and contains 27 items with a global HRQL score and physical limitation and emotional, and social function subscales with a 2-week timeframe. The maximum possible score in any domain is 7 and the minimum is 1. The higher score means a better outcome.
arm group label: Intermittent Exercise Group
arm group type: Experimental
description: Warm-up, loading (walking, squat, sitting down on a chair, limb movements with weights, stepping on steps, walking on different floors), cooling and relaxation exercises
arm group label: Control Group
arm group type: Active Comparator
description: Warm-up, loading (brisk walking at 60-85% of maximum heart rate), cooling and relaxation exercises
intervention type: Other
intervention name: Intermittent Exercise
description: Exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. During the loading period, taking into consideration the heart rate, fatigue and shortness of breath, exercises such as walking, squat, limb movements with weights, stepping on the steps, walking on different floors are shown. Stretching exercises are done during the cooling period. Intermittent loading workouts will consist of 3-minute loads and 1-minute rest intervals. Participants are contacted every two weeks via communication methods such as e-mail, message and telephone conversation. Exercise diary is given to all patients and is taken from them at the end of the study.
arm group label: Intermittent Exercise Group
intervention type: Other
intervention name: Control
description: Exercise programs including warm-up, loading, cooling, and relaxation exercises are shown. The warm-up period is consist of light-paced walking, active movements of several large muscle groups. In loading period, moderate aerobic exercise is consist of brisk walking to reach 60-85% of the person's maximum heart rate. Stretching exercises are done during the cooling period.
arm group label: Control Group
criteria: 
gender: All
minimum age: 35 Years
maximum age: N/A
healthy volunteers: No
last name: Elvan Keleş, PT, MSc
phone: 0902323293535
email: elvan_keles@yahoo.com
last name: Hazal Yakut, PT, MSc
email: fzthazalyakut@outlook.com
facility: 
status: Recruiting
contact: 
investigator: 
investigator: 
investigator: 
investigator: 
investigator: 
country: Turkey
responsible party type: Principal Investigator
investigator affiliation: Dokuz Eylul University
investigator full name: Elvan Keles
investigator title: Research Assistant
mesh term: Myocardial Infarction
mesh term: Infarction