No benefit of additional treatment with exenatide in patients with an acute myocardial infarction

被引:35
作者
Roos, Sebastiaan T. [1 ,2 ]
Timmers, Leo [3 ]
Biesbroek, Paul S. [1 ,2 ]
Nijveldt, Robin [1 ]
Kamp, Otto [1 ,2 ]
van Rossum, Albert C. [1 ,2 ]
van Hout, Gerardus P. J. [3 ]
Stella, Pieter R. [3 ]
Doevendans, Pieter A. [3 ]
Knaapen, Paul [1 ]
Velthuis, Birgitta K. [4 ]
van Royen, Niels [1 ]
Voskuil, Michiel [3 ]
Nap, Alex [1 ]
Appelman, Yolande [1 ,2 ]
机构
[1] Vrije Univ Amsterdam Med Ctr, Dept Cardiol, Inst Cardiovasc Res ICaR VU, Amsterdam, Netherlands
[2] ICIN, Utrecht, Netherlands
[3] Univ Med Ctr Utrecht, Dept Cardiol, Utrecht, Netherlands
[4] Univ Med Ctr Utrecht, Dept Radiol, Utrecht, Netherlands
关键词
Coronary artery disease; Exenatide; Myocardial infarction; Infarct size; PERCUTANEOUS CORONARY INTERVENTION; GLUCAGON-LIKE PEPTIDE-1; REPERFUSION INJURY; ISCHEMIA/REPERFUSION; ISCHEMIA; EDEMA; RISK; SIZE; AREA;
D O I
10.1016/j.ijcard.2016.06.283
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives: This double blinded, placebo controlled randomized clinical trial studies the effect of exenatide on myocardial infarct size. The glucagon-like peptide-1 receptor agonist exenatide has possible cardioprotective properties during reperfusion after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. Methods: 191 patients were randomly assigned to intravenous exenatide or placebo initiated prior to percutaneous coronary intervention using 10 mu g/h for 30 min followed by 0.84 mu g/h for 72 h. Patients with a previous myocardial infarction, Trombolysis in Myocardial Infarction flow 2 or 3, multi-vessel disease, or diabetes were excluded. Magnetic resonance imaging (MRI) was performed to determine infarct size, area at risk (AAR) (using T2-weighted hyperintensity (T2W) and late enhancement endocardial surface area (ESA)). The primary endpoint was of 4-month final infarct size, corrected for the AAR measured in the acute phase using MRI. Results: After exclusion, 91 patients (age 57.4 +/- 10.1 years, 76% male) completed the protocol. There were no baseline differences between groups. No difference was found in infarct size corrected for the AAR in the exenatide group compared to the placebo group (37.1 +/- 18.8 vs. 39.3 +/- 20.1%, p = 0.662). There was also no difference in infarct size (18.8 +/- 13.2 vs. 18.8 +/- 11.3% of left ventricula mass, p = 0.965). No major adverse cardiac events occurred during the in-hospital phase. Conclusion: Exenatide did not reduce myocardial infarct size expressed as a percentage of AAR in ST elevated myocardial infarction patients successfully treated with percutaneous coronary intervention. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:809 / 814
页数:6
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