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Effects of Melatonin on Reperfusion Injury

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Chinese PLA General Hospital

Keywords

Abstract

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. Melatonin is the chief indoleamine produced by the pineal gland, and a well-known antioxidant and free radical scavenger. Several studies have shown that melatonin protects against ischemia/reperfusion injury (IRI). In our previous study, melatonin markedly reduced infarcted area, improved cardiac function and reduced lactate dehydrogenase release in rats. The investigators planned to research the cardioprotective effects of intravenous melatonin administered prior to reperfusion and continued after restoration of coronary blood flow in patients with ST segment elevation myocardial infarction undergoing pPCI.

Dates

Last Verified: 09/30/2017
First Submitted: 10/01/2017
Estimated Enrollment Submitted: 10/03/2017
First Posted: 10/05/2017
Last Update Submitted: 10/03/2017
Last Update Posted: 10/05/2017
Actual Study Start Date: 10/31/2017
Estimated Primary Completion Date: 10/31/2019
Estimated Study Completion Date: 10/31/2019

Condition or disease

Reperfusion Injury, Myocardial

Intervention/treatment

Drug: Melatonin group

Drug: Control group

Phase

-

Arm Groups

ArmIntervention/treatment
Experimental: Melatonin group
Patients will receive a total intravenous melatonin dose of 11.61 mg (aproximately 166 μg/kg).
Drug: Melatonin group
Patients will receive a total intravenous melatonin (Helsinn Chemical Co, Biasca, Switzerland) dose of 11.61 mg (aproximately 166 μg/kg). The dose will be distributed in a volume of 500 ml of an isotonic and sterile solution of 100 μM melatonin during 150 min with a drip rate of 4.2 ml/min. The temporal distribution of perfusion will be: 30 min previous to percutaneous revascularization and remainder doses in a subsequent 120 min (1 h during the angioplasty +60 min post-intervention).
Placebo Comparator: Control group
Patients will receive the same dose of placebo.
Drug: Control group
The temporal distribution of perfusion will be: 30 min previous to percutaneous revascularization and remainder doses in a subsequent 120 min (1 h during the angioplasty +60 min post-intervention).

Eligibility Criteria

Ages Eligible for Study 18 Years To 18 Years
Sexes Eligible for StudyAll
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

ST segment elevation myocardial infarction undergoing primary percutaneous poronary intervention

Exclusion Criteria:

- unconscious at presentation

- had cardiogenic shock

- had a history of myocardial infarction

- stent thrombosis

- renal insufficiency

- had previously undergone coronary artery bypass surgery

Outcome

Primary Outcome Measures

1. The salvage index [3 months after primary percutaneous coronary intervention]

The salvage index measured by cardiac magnetic resonance

Secondary Outcome Measures

1. The final infarct size [3 months after primary percutaneous coronary intervention]

The final infarct size measured by cardiac magnetic resonance

2. major adverse cardiovascular events (MACE) [3 months after primary percutaneous coronary intervention]

recurrent myocardial infarction, recurrent angina, revascularization, heart failure, cardiac death.

3. treatment-emergent adverse events (TEAEs) [3 months after primary percutaneous coronary intervention]

hypoglycemia, nausea

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