Document Detail


Poloxamer-188 as an adjunct to primary percutaneous transluminal coronary angioplasty for acute myocardial infarction.
MedLine Citation:
PMID:  8857476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Poloxamer-188 is a surfactant polymer with antithrombotic and hemorheologic properties that make it potentially useful as an adjunct to acute reperfusion strategies. Animal studies and early human studies have documented poloxamer-188 to be effective at improving myocardial salvage when used as an adjunct to intravenous thrombolytic therapy for acute myocardial infarction. The current trial was a prospective pilot study involving 150 patients who were randomized in a 2:1 fashion to a poloxamer-188 infusion for 48-hours versus placebo. The poloxamer-188 infusion was well tolerated subjectively. The only clinically significant laboratory abnormality noted was an elevation in the serum creatinine above 2.0 g/dl in 12% (n = 12) of the 98 poloxamer-188 treated patients versus 1 of the 52 (2%) of the placebo treated patients (p = 0.048). Clinical end points including reinfarction (1% vs 4%), cardiogenic shock (7% vs 6%), and death (9% vs 4%) were statistically similar in the poloxamer-188 and placebo groups, respectively (p = NS). Using quantitative nuclear techniques, final infarct size and myocardial salvage were statistically similar in the poloxamer-188 and placebo groups. Mean left ventricular ejection fractions 1 week post after infarction were 51% +/- 12% in the poloxamer-188 group and 52% +/- 13% in the placebo group (p = NS). Final infarct size, was not altered by the poloxamer- 188 infusion; however, it was significantly correlated with normal perfusion (Thrombolysis in Myocardial Infarction grade 3 flow) in the infarct vessel after angioplasty. This study documented poloxamer-188 to be ineffective as an adjunct to primary angioplasty for acute myocardial infarction and resulted in azotemia in 12% of the patients.
Authors:
J H O'Keefe; C L Grines; M A DeWood; G L Schaer; K Browne; R D Magorien; J M Kalbfleisch; W O Fletcher; T M Bateman; R J Gibbons
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase II; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-11-27     Completed Date:  1996-11-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  747-50     Citation Subset:  AIM; IM    
Affiliation:
Mid America Heart Institute, St. Luke's Hospital, University of Missouri-Kansas City, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Creatinine / blood
Double-Blind Method
Female
Humans
Infusions, Intravenous
Male
Middle Aged
Myocardial Infarction / blood,  therapy*
Pilot Projects
Poloxalene / administration & dosage*
Prospective Studies
Surface-Active Agents / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Surface-Active Agents; 60-27-5/Creatinine; 9003-11-6/Poloxalene

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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