Effect of Intracoronary and Intravenous Melatonin on Myocardial Salvage Index in Patients with ST-Elevation Myocardial Infarction: a Randomized Placebo Controlled Trial.
Sarah EkeloefNatalie HalladinSiv FonnesSvend Eggert JensenTomas ZarembaJacob RosenbergGrete JonssonJens AarøeLærke Smidt GasbjergMette Marie RosenkildeIsmail GögenurPublished in: Journal of cardiovascular translational research (2017)
Melatonin has attenuated myocardial ischemia reperfusion injury in experimental studies. We hypothesized that the administration of melatonin during acute myocardial reperfusion improves myocardial salvage index in patients with ST-elevation myocardial infarction. Patients (n = 48) were randomized in a 1:1 ratio to intracoronary and intravenous melatonin (total 50 mg) or placebo. The myocardial salvage index assessed by cardiac magnetic resonance imaging at day 4 (± 1 day) after primary percutaneous coronary intervention was similar in the melatonin group (n = 22) at 55.3% (95% CI 47.0-63.6) and the placebo group (n = 19) at 61.5% (95% CI 57.5-65.5), p = 0.21. The levels of high-sensitive troponin T, creatinine kinase myocardial band, and oxidative biomarkers (advanced oxidation protein products, malondialdehyde, myeloperoxidase) were similar in the groups. The frequency of clinical events at 90 days did not differ between the groups. In conclusion, melatonin did not improve the myocardial salvage index after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction compared with placebo.
Keyphrases
- st elevation myocardial infarction
- percutaneous coronary intervention
- left ventricular
- acute myocardial infarction
- st segment elevation myocardial infarction
- acute coronary syndrome
- coronary artery disease
- double blind
- antiplatelet therapy
- coronary artery bypass grafting
- magnetic resonance imaging
- atrial fibrillation
- placebo controlled
- heart failure
- phase iii
- open label
- clinical trial
- high dose
- low dose
- end stage renal disease
- chronic kidney disease
- randomized controlled trial
- metabolic syndrome
- computed tomography
- brain injury
- uric acid
- respiratory failure
- amino acid
- case control
- drug induced