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document
The effect of prethrombolytic cyclosporine-A injection on clinical outcome of acute anterior ST-elevation myocardial infarction . INTRODUCTION Reperfusion injury reduces the benefits of early reperfusion therapies after acute ST-elevation myocardial infarction ( STEMI ) . Cyclosporine-A ( CsA ) is a potent inhibitor of opening of the mitochondrial permeability transition pore , which has been shown to play a key role in myocardial reperfusion injury . The impact of this treatment on clinical outcomes of acute STEMI remains unknown . Our aim was to investigate the clinical outcomes of using this drug in patients with acute anterior STEMI receiving thrombolytic treatment ( TLT ) . METHODS In this double-blinded randomized clinical trial , 101 patients with acute anterior STEMI who were candidate for TLT , were enrolled and randomly assigned into treatment or control groups . Patients in the treatment group received an intravenous bolus injection of 2.5 mg/kg of CsA immediately before TLT . The patients in the control group received an equivalent volume of normal saline . Infarct size , occurrence of major arrhythmias , heart failure , left ventricular ejection fraction ( LVEF ) , TLT-related complications , in-hospital and 6-month mortality rates were investigated . RESULTS There were no significant differences among the demographics , myocardial enzyme release , occurrence of major arrhythmias [ 9 ( 18 % ) vs. 12 ( 23.5 % ) , P = 0.80 ] , heart failure [ 18 ( 36 % ) vs. 19 ( 38.3 % ) , P = 0.83 ] , LVEF at first day [ 34.7 ± 9.9 % vs. 33.5 ± 8.1 % , P = 0.50 ] or at discharge [ 37.7 ± 10 % vs. 36.1 ± 8.2 % , P = 0.43 ] , and in-hospital [ 4 ( 8 % ) vs. 6 ( 11.8 % ) , P = 0.74 ] or 6-month mortality rates [ 9 ( 18 % ) vs. 10 ( 19.6 % ) , P = 0.99 ] between the CsA vs. the control group . CONCLUSION In this study , the prethrombolytic administration of CsA was not associated with a reduction in the infarct size or any improvement in clinical outcomes .
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Intervention_Pharmacological
prethrombolytic cyclosporine-A injection
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Intervention_Pharmacological
Cyclosporine-A ( CsA )
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Intervention_Pharmacological
CsA
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Intervention_Control
normal saline
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Outcome_Physical
Infarct size , occurrence of major arrhythmias , heart failure , left ventricular ejection fraction ( LVEF ) ,
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Outcome_Adverse-effects
TLT-related complications
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Outcome_Physical
,
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Outcome_Mortality
in-hospital and 6-month mortality rates
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Outcome_Physical
demographics , myocardial enzyme release , occurrence of major arrhythmias
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Outcome_Physical
heart failure
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Outcome_Physical
LVEF at first day
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Outcome_Mortality
6-month mortality rates
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Participant_Condition
acute anterior ST-elevation myocardial infarction .
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Participant_Condition
patients with acute anterior STEMI receiving thrombolytic treatment ( TLT ) .