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Effects of Melatonin on Reperfusion Injury

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Mots clés

Abstrait

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.

Rendez-vous

Dernière vérification: 09/30/2017
Première soumission: 10/01/2017
Inscription estimée soumise: 10/03/2017
Première publication: 10/05/2017
Dernière mise à jour soumise: 10/03/2017
Dernière mise à jour publiée: 10/05/2017
Date de début réelle de l'étude: 10/31/2017
Date d'achèvement primaire estimée: 10/31/2019
Date estimée d'achèvement de l'étude: 10/31/2019

Condition ou maladie

Reperfusion Injury, Myocardial

Intervention / traitement

Drug: Melatonin group

Drug: Control group

Phase

-

Groupes d'armes

BrasIntervention / traitement
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).

Critère d'éligibilité

Âges éligibles aux études 18 Years À 18 Years
Sexes éligibles à l'étudeAll
Accepte les bénévoles en santéOui
Critères

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

Résultat

Mesures des résultats primaires

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

The salvage index measured by cardiac magnetic resonance

Mesures des résultats secondaires

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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