Effects of Glucagon Like Peptide-1 on No-reflow
Keywords
Coimriú
Cur síos
Acute myocardial infarction (AMI) is a major cause of mortality and morbidity. Primary percutaneous coronary intervention (PCI) is currently the most effective treatment strategy for AMI. Brisk thrombolysis in myocardial infarction (TIMI) grade 3 flow immediately after PCI in patients with AMI is associated with improved clinical outcomes compared with lower flow grades. However, myocardial reperfusion is suboptimal in many patients, mostly because of the 'no-reflow' phenomenon. No-reflow is defined as suboptimal myocardial reperfusion in part of the coronary circulation without angiographic evidence of mechanical vessel obstruction. To date, however, very few drugs have been shown to reverse established no-reflow.
Glucagon-like peptide-1 (GLP-1) is an incretin hormone that regulates plasma glucose, and GLP-1 analogues were recently introduced for the treatment of acute myocardial infarction. GLP-1 has antioxidant and anti-inflammatory properties, and may protect endothelial function. Experimental studies have also revealed that GLP-1 or its analogues protect against reperfusion injury in pigs. Exenatide, a GLP-1 analogue, was reported to reduce reperfusion injury in patients with ST-segment elevation myocardial infarction. Similarly, liraglutide was reported to reduce cardiac rupture and infarct size and improve cardiac output in normal and diabetic mice. To date, however, there is no clinical evidence for the effects of liraglutide on no-reflow in patients with AMI. Therefore, the aim of this study was to evaluate the effects of liraglutide pretreatment on myocardial no-reflow of prime PCI in patients with AMI.
Dátaí
| Fíoraithe Deireanach: | 06/30/2015 |
| Cuireadh isteach den chéad uair: | 07/21/2015 |
| Clárú Measta Curtha isteach: | 07/21/2015 |
| Arna chur suas ar dtús: | 07/22/2015 |
| Nuashonrú Deireanach Curtha isteach: | 07/21/2015 |
| Nuashonrú Deireanach Postáilte: | 07/22/2015 |
| Dáta Tosaigh an Staidéir Iarbhír: | 06/30/2015 |
| Dáta Críochnaithe Bunscoile Measta: | 06/30/2016 |
| Dáta Críochnaithe an Staid Mheasta: | 06/30/2016 |
Coinníoll nó galar
Idirghabháil / cóireáil
Drug: GLP-1 group
Drug: Control group
Céim
Grúpaí Láimhe
| Lámh | Idirghabháil / cóireáil |
|---|---|
| Experimental: GLP-1 group The treatment started 30 min before PCI with a dose of 1.8 mg liraglutide (the treatment was administered in the ambulance). | Drug: GLP-1 group Liraglutide were taken 30 min before PCI. |
| Placebo Comparator: Control group the treatment started 30 min before PCI with a dose of 1.8 mg placebo (the treatment was administered in the ambulance). | Drug: Control group Placebo were taken 30 min before PCI. |
Critéir Incháilitheachta
| Aois Incháilithe le haghaidh Staidéir | 18 Years Chun 18 Years |
| Gnéas Incháilithe le haghaidh Staidéir | All |
| Glacann Oibrithe Deonacha Sláintiúla | Sea |
| Critéir | Inclusion Criteria: Patients with ST-segment elevation myocardial infarction were eligible for the study. Exclusion Criteria: Patients were excluded for the following reasons: unconscious at presentation; had cardiogenic shock, hypoglycaemia, or diabetic ketoacidosis; had a history of myocardial infarction, stent thrombosis, or renal insufficiency; or had previously undergone coronary artery bypass surgery. |
Toradh
Bearta Toraidh Príomhúla
1. a change in the prevalence of no-reflow [immediately after PCI]
Bearta Torthaí Tánaisteacha
1. a change in troponin T [immediately after PCI, at 1,3,5 days after PCI]
2. a change in high-sensitivity C-reactive protein (hsCRP) [immediately after PCI, at 1,3,5 days after PCI]
3. a change in superoxide dismutase (SOD) [immediately after PCI, at 1,3,5 days after PCI]
Bearta Toraidh Eile
1. differences in the incidences of treatment-emergent adverse events [immediately after PCI, at 1,3,5 days after PCI]
