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Improving RBC K transport and hemoglobin-O2 binding by amiloride : A novel therapeutic approach for reversion of angina and myocardial ischemia in coronary heart diseases . UNLABELLED Coronary heart disease ( CHD ) is the leading cause of morbidity and mortality across the entire world , in which reversion of angina or improvement of ECG remains an unrealistic therapeutic option for most patients , suggesting that microvascular dysfunction or impaired oxygen delivery might be critical factors in CHD . This research article , thus presents the rationale basis , clinical and experimental , for the first therapeutic innovation addressing the role of red blood cell ( RBC ) H/K and O2/CO2 exchanges in CHD . It is followed by a randomized single-blind trial of Amiloride and Optimal Medical Therapy ( OMT , n=35 cases ) vs OMT alone ( n=35 cases ) in patients having angina , ST-T alteration and a defective RBC-K transport . All patients had serial clinical evaluation , Ion Transport Studies , ECGs and non-invasive aortic waveform and cardiovascular hemodynamic recordings . Statistical analysis was performed by SAS . RESULTS Amiloride rapidly improved RBC-K ( 93.5 ±4 vs 84.5 ±4 mmol/lc , p= < 0.001 ) , angina ( 80 % of cases , 1.5 ±0.3 weeks , CI:1.72 to 1.45 ) , CCS Class ( 1.3 ±0.5 vs 3.1 ±0.8 , p < 0.001 ) vs patients with OMT alone CCS Class ( 3.2 ± 0.4 vs 3.3 ± 0.5 , p =0.21 ) . Reversion of angina was sustained through the next 6-months ( 87 % vs 26 % in OMT , RR 2.1 , odds ratio 6.31 , Pearson x2 34.6 , p < 0.0001 at 95 % CI ) and 1-year ( 85 % vs 37 % OMT ) . At 6-months of amiloride , ECG became normal ( 29 % vs 0 % , RR ∞ uncalculated-time , odds ratio ∞ , Pearson x2 42.4 at 95 % CI , p < 0.0001 ) , improved ( 55 % vs 29 % ; RR2.1 , odds ratio 3.16 , 95 % CI , p < 0.0001 ) or unchanged ( 15 % vs 67 % OMT ) . At 1-year , seven patients on amiloride ( 18 % ) exhibited evidence of electrical regeneration of the heart , not observed with placebo . IN CONCLUSION This therapeutical innovation of amiloride improves RBC H/K and O2/CO2 function , and reverses angina , ST-T alterations while inducing electrical regeneration of the heart , in patients receiving optimal medical treatment for angina . The article has short discussion on the relevant patents to the topic .
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Intervention_Pharmacological
amiloride
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Intervention_Pharmacological
Amiloride
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Intervention_Pharmacological
Optimal Medical Therapy
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Intervention_Pharmacological
OMT alone
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Participant_Condition
coronary heart diseases .
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Participant_Condition
angina
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Participant_Condition
ST-T alteration