Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction
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Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. / Lønborg, Jacob; Vejlstrup, Niels; Kelbæk, Henning; Bøtker, Hans Erik; Kim, Won Yong; Mathiasen, Anders B; Jørgensen, Erik; Helqvist, Steffen; Saunamäki, Kari; Clemmensen, Peter; Holmvang, Lene; Thuesen, Leif; Krusell, Lars Romer; Jensen, Jan S; Køber, Lars; Treiman, Marek; Holst, Jens Juul; Engstrøm, Thomas.
In: European Heart Journal, Vol. 33, No. 12, 2011, p. 1491-9.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction
AU - Lønborg, Jacob
AU - Vejlstrup, Niels
AU - Kelbæk, Henning
AU - Bøtker, Hans Erik
AU - Kim, Won Yong
AU - Mathiasen, Anders B
AU - Jørgensen, Erik
AU - Helqvist, Steffen
AU - Saunamäki, Kari
AU - Clemmensen, Peter
AU - Holmvang, Lene
AU - Thuesen, Leif
AU - Krusell, Lars Romer
AU - Jensen, Jan S
AU - Køber, Lars
AU - Treiman, Marek
AU - Holst, Jens Juul
AU - Engstrøm, Thomas
PY - 2011
Y1 - 2011
N2 - Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.
AB - Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.
U2 - 10.1093/eurheartj/ehr309
DO - 10.1093/eurheartj/ehr309
M3 - Journal article
C2 - 21920963
VL - 33
SP - 1491
EP - 1499
JO - European Heart Journal
JF - European Heart Journal
SN - 0195-668X
IS - 12
ER -
ID: 38432999