| Effect of Iron Chelation on Myocardial Infarct Size and Oxidative Stress in ST-Elevation-Myocardial Infarction. | |
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MedLine Citation:
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PMID: 22496085 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Experimental studies suggest that deferoxamine (DFO) limits the generation of reactive oxygen species by chelating redox-active iron and thereby may reduce ischemia-reperfusion injury and myocardial infarct (MI) size. We investigated whether DFO administered before reperfusion by primary percutaneous coronary intervention (PPCI) would ameliorate oxidative stress and MI size. METHODS AND RESULTS: We randomly assigned 60 patients with ST-elevation-MI to receive an intravenous bolus of DFO (500 mg) immediately before PPCI followed by a 12-hour infusion (50 mg/kg of body weight) (n=28) or normal saline bolus and infusion (placebo group, n=32). MI size was measured by contrast-enhanced cardiac MRI (CMRI; day 3±1), creatine kinase and troponin I area-under-the-curve, and severity of wall motion abnormality on echocardiography. Clinical follow-up including repeat CMRI and echocardiography were performed at 3 months (100±17 days). Oxidative stress was assessed by plasma F(2)-isoprostane levels. DFO and placebo groups were well balanced with respect to baseline characteristics, symptom- and door-to-balloon times, pre-PPCI coronary patency, and infarct-related artery location. Serum iron levels were decreased with DFO treatment after PPCI compared with placebo (3.0±2.5 versus 12.6±5.5 μmol/L, P<0.0001), which persisted until the end of the infusion. In DFO-treated patients, there was a significant reduction in plasma F(2)-isoprostane levels immediately after PPCI (2878±1461 versus 2213±579 pmol/L, P=0.04). However, there was no difference in CMRI-determined infarct size (DFO, 17.4±10.8%, versus placebo, 18.6±10.2%; P=0.73), myocardial salvage index at 3 days or at 3 months, or the area-under-the-curve for creatine kinase or troponin I. CONCLUSIONS: Adjunctive DFO treatment after the onset of ischemia and continued periprocedurally ameliorates oxidative stress without limiting infarct size. CLINICAL TRIAL REGISTRATION: URL: http://www.anzctr.org.au/. Unique identifier: ACTRN12608000308392. |
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Authors:
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William Chan; Andrew J Taylor; Andris H Ellims; Lisa Lefkovits; Chiew Wong; Bronwyn A Kingwell; Alaina Natoli; Kevin D Croft; Trevor Mori; David M Kaye; Anthony M Dart; Stephen J Duffy |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-10 |
Journal Detail:
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Title: Circulation. Cardiovascular interventions Volume: - ISSN: 1941-7632 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101499602 Medline TA: Circ Cardiovasc Interv Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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