Myocardial Infarction Clinical Trial
Official title:
Tetracycline (Doxycycline) In Patients With Large Acute Myocardial Infarction TO Prevent Left Ventricular Remodeling. TIPTOP Study
The aim of the study is to assess the efficacy of an antibiotic treatment with tetracycline (doxycycline) in the early stage of large reperfused acute myocardial infarction (AMI), in preventing left ventricular (LV) remodeling.
A myocardial interstitial matrix, that provides structural support and integrity to the
myocardium, is a key element to determine post infarction left ventricular remodeling (LVR).
The metalloproteinases (MMPs), an enzymatic system secreted in the extracellular medium by
macrophages, has been shown to be able to degrade the most important extracellular matrix
components.
Various animal experimental models have demonstrated that MMP specific inhibition in the
first phase of myocardial infarction is able to contrast LVR. Doxycycline, a member of the
tetracyclines, has been shown to block various inflammation mediators and to attenuate MMP-2
and MMP-9 expression and activity at a sub-antimicrobial dosage. Some experimental studies
on rat models have suggested an anti-remodeling effect of doxycycline in myocardial
infarction.
In the present study we want to evaluate if a treatment with doxycycline (100 mg b.i.d.) in
the first seven days after a reperfused large (ejection fraction less than 40%) acute
myocardial infarction, is effective in preventing six-month LVR.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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