期刊
EUROPEAN HEART JOURNAL
卷 33, 期 12, 页码 1491-1499出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehr309
关键词
Reperfusion injury; Exenatide; Acute myocardial infarction; Cardiac magnetic; Resonance; Primary percutaneous coronary intervention
资金
- Danish National Research Foundation for Heart Arrhythmia
- Novo Nordisk Foundation
- Danielsen's Foundation
- Rigshospitalet's Research Foundation
- Danish Heart Foundation
Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 0.13 vs. 0.62 0.16; P 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 0.15 vs. 0.39 0.15; P 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 9 vs. 17 14 g; P 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据