Acute Myocardial Infarction
Conditions
Keywords
Reperfusion injury, Liraglutide
Brief summary
The investigators planned to research the cardioprotective effects of intravenous liraglutide on reperfusion injury.
Detailed description
Acute myocardial infarction is a major cause of mortality and morbidity. Primary percutaneous coronary intervention (pPCI) is currently the most effective treatment strategy in acute myocardial infarction. However, a sizable number of patients fail to restore optimal myocardial reperfusion, mostly because of the 'no-reflow' phenomenon. Glucagon-like peptide-1 (GLP-1) is an incretin hormone that regulates plasma glucose, and recently GLP-1 analogues have been introduced for the treatment of type-2 diabetes. In experimental studies, GLP-1 or its analogues protect against reperfusion injury-induced cell death. Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. Liraglutide(GLP-1) is safe and effective to reduce weight,serum lipid levels and blood pressure. Liraglutide can reduce cardiac rupture (12 of 60 versus 46 of 60; P=0.0001) and infarct size (21±2% versus 29±3%, P=0.02) and improved cardiac output (12.4±0.6 versus 9.7±0.6 ml/min; P=0.002) in normal and diabetic mice. The investigators planned to research the cardioprotective effects of intravenous liraglutide administered prior to reperfusion and continued after restoration of coronary blood flow in patients with STEMI undergoing pPCI.
Interventions
DRUGliraglutide placebo (Novo Nordisk)
once-daily subcutaneous liraglutide placebo 0.6 mg for 2 days, then gradually increase the dosage, once-daily subcutaneous liraglutide placebo 1.2 mg for 2 days ,once-daily subcutaneous liraglutide placebo 1.8 mg for 3 days
DRUGliraglutide (Novo Nordisk, Bagsværd, Denmark)
once-daily subcutaneous liraglutide 0.6 mg for 2 days, then gradually increase the dosage, once-daily subcutaneous liraglutide 1.2 mg for 2 days ,once-daily subcutaneous liraglutide 1.8 mg for 3 days
Sponsors
Chen Wei Ren, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients were eligible if they were 18 years or older and presented within 12 h from the onset of symptoms and signs of ST-segment elevation myocardial infarction to the catheterization laboratory.
Exclusion criteria
The patients were not considered for enrolment if they presented with unconsciousness, cardiogenic shock, hypoglycaemia, diabetic ketoacidosis, previous myocardial infarction, stent thrombosis, known renal insufficiency, or previous coronary artery bypass operation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| the salvage index measured by cardiac magnetic resonance | 3 months after primary percutaneous coronary intervention | The primary endpoint was the salvage index measured by cardiac magnetic resonance after 3 months. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| major adverse cardiovascular events (MACE) after 3 months | 3 months after Primary percutaneous coronary intervention | major adverse cardiovascular events (MACE) after 3 months: recurrent myocardial infarction, recurrent angina, revascularization, heart failure, cardiac death. treatment-emergent adverse events (TEAEs): hypoglycemia, nausea, acute pancreatitis |
| final infarct size after 3 months | 3 months after Primary percutaneous coronary intervention | — |
| the levels of high-sensitivity C-reactive protein (hsCRP) | 3 months after Primary percutaneous coronary intervention | — |
| nitric oxide (NO) levels | 3 months after Primary percutaneous coronary intervention | — |
Countries
China
Contacts
Primary ContactWei Ren Chen, M.D.
Outcome results
None listed