Acute ST-segment Elevation Myocardial Infarction Clinical Trial
Official title:
Effects of Glucagon Like Peptide-1 on No-reflow in Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
The investigators planned to evaluate the effects of liraglutide on no-reflow in patients with acute ST-segment elevation myocardial infarction (STEMI).
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.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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