Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction

Jacob Lønborg; Niels Vejlstrup; Henning Kelbæk; Hans Erik Bøtker; Won Yong Kim; Anders B Mathiasen; Erik Jørgensen; Steffen Helqvist; Kari Saunamäki; Peter Clemmensen; Lene Holmvang; Leif Thuesen; Lars Romer Krusell; Jan S Jensen; Lars Køber; Marek Treiman; Jens Juul Holst; Thomas Engstrøm

doi:10.1093/eurheartj/ehr309

Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction

Jacob Lønborg, Niels Vejlstrup, Henning Kelbæk, Hans Erik Bøtker, Won Yong Kim, Anders B Mathiasen, Erik Jørgensen, Steffen Helqvist, Kari Saunamäki, Peter Clemmensen, Lene Holmvang, Leif Thuesen, Lars Romer Krusell, Jan S Jensen, Lars Køber, Marek Treiman, Jens Juul Holst, Thomas Engstrøm

393 Citationer (Scopus)

Abstract

Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.

Originalsprog	Engelsk
Tidsskrift	European Heart Journal
Vol/bind	33
Udgave nummer	12
Sider (fra-til)	1491-9
Antal sider	9
ISSN	0195-668X
DOI	https://doi.org/10.1093/eurheartj/ehr309
Status	Udgivet - jun. 2012

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10.1093/eurheartj/ehr309

https://academic.oup.com/eurheartj/article-pdf/33/12/1491/9628589/ehr309.pdf

Citationsformater

Lønborg, J., Vejlstrup, N., Kelbæk, H., Bøtker, H. E., Kim, W. Y., Mathiasen, A. B., Jørgensen, E., Helqvist, S., Saunamäki, K., Clemmensen, P., Holmvang, L., Thuesen, L., Krusell, L. R., Jensen, J. S., Køber, L., Treiman, M., Holst, J. J., & Engstrøm, T. (2012). Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. European Heart Journal, 33(12), 1491-9. https://doi.org/10.1093/eurheartj/ehr309

Lønborg, J, Vejlstrup, N, Kelbæk, H, Bøtker, HE, Kim, WY, Mathiasen, AB, Jørgensen, E, Helqvist, S, Saunamäki, K, Clemmensen, P, Holmvang, L, Thuesen, L, Krusell, LR, Jensen, JS, Køber, L, Treiman, M, Holst, JJ & Engstrøm, T 2012, 'Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction', European Heart Journal, bind 33, nr. 12, s. 1491-9. https://doi.org/10.1093/eurheartj/ehr309

@article{36b2a324cfe3426189272dbb609dfe80,

title = "Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction",

abstract = "Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.",

author = "Jacob L{\o}nborg and Niels Vejlstrup and Henning Kelb{\ae}k and B{\o}tker, {Hans Erik} and Kim, {Won Yong} and Mathiasen, {Anders B} and Erik J{\o}rgensen and Steffen Helqvist and Kari Saunam{\"a}ki and Peter Clemmensen and Lene Holmvang and Leif Thuesen and Krusell, {Lars Romer} and Jensen, {Jan S} and Lars K{\o}ber and Marek Treiman and Holst, {Jens Juul} and Thomas Engstr{\o}m",

year = "2012",

month = jun,

doi = "10.1093/eurheartj/ehr309",

language = "English",

volume = "33",

pages = "1491--9",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "12",

}

TY - JOUR

T1 - Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction

AU - Lønborg, Jacob

AU - Vejlstrup, Niels

AU - Kelbæk, Henning

AU - Bøtker, Hans Erik

AU - Kim, Won Yong

AU - Mathiasen, Anders B

AU - Jørgensen, Erik

AU - Helqvist, Steffen

AU - Saunamäki, Kari

AU - Clemmensen, Peter

AU - Holmvang, Lene

AU - Thuesen, Leif

AU - Krusell, Lars Romer

AU - Jensen, Jan S

AU - Køber, Lars

AU - Treiman, Marek

AU - Holst, Jens Juul

AU - Engstrøm, Thomas

PY - 2012/6

Y1 - 2012/6

N2 - Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.

AB - Aims Exenatide, a glucagon-like-peptide-1 analogue, increases myocardial salvage in experimental settings with coronary occlusion and subsequent reperfusion. We evaluated the cardioprotective effect of exenatide at the time of reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods and results A total of 172 patients with STEMI and Thrombolysis in Myocardial Infarction flow 0/1 were randomly assigned to exenatide or placebo (saline) intravenously. Study treatment was commenced 15 min before intervention and maintained for 6 h after the procedure. The primary endpoint was salvage index calculated from myocardial area at risk (AAR), measured in the acute phase, and final infarct size measured 90 ± 21 days after pPCI by cardiac magnetic resonance (CMR). In 105 patients evaluated with CMR, a significantly larger salvage index was found in the exenatide group than in the placebo group (0.71 ± 0.13 vs. 0.62 ± 0.16; P= 0.003). Infarct size in relation to AAR was also smaller in the exenatide group (0.30 ± 0.15 vs. 0.39 ± 0.15; P= 0.003). In a regression analysis, there was a significant correlation between the infarct size and the AAR for both treatment groups and an analysis of covariance showed that datapoints in the exenatide group lay significantly lower than for the placebo group (P= 0.011). There was a trend towards smaller absolute infarct size in the exenatide group (13 ± 9 vs. 17 ± 14 g; P= 0.11). No difference was observed in left ventricular function or 30-day clinical events. No adverse effects of exenatide were observed. Conclusion In patients with STEMI undergoing pPCI, administration of exenatide at the time of reperfusion increases myocardial salvage.

U2 - 10.1093/eurheartj/ehr309

DO - 10.1093/eurheartj/ehr309

M3 - Journal article

C2 - 21920963

SN - 0195-668X

VL - 33

SP - 1491

EP - 1499

JO - European Heart Journal

JF - European Heart Journal

IS - 12

ER -

Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction

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