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Objective-Experimental evidence suggests that exenatide, a glucagon-like peptide 1 receptor analogue, has significant cardiovascular protective effects in various conditions. We examined whether routine use of exenatide at the time of primary percutaneous coronary intervention would reduce infarct size in patients with ST-segment-elevation myocardial infarction. Approach and Results-Fifty-eight patients with ST-segment-elevation myocardial infarction and thrombolysis in myocardial infarction flow 0 were enrolled in the study and randomly assigned to receive either exenatide or placebo (saline) subcutaneously. Infarct size was assessed by measuring the release of creatine kinase-MB and troponin I during 72 hours and by performing cardiac magnetic resonance imaging at 1 month after infarction. Routine and speckle tracking echocardiography was performed at initial presentation and at 3 days and 6 months after primary percutaneous coronary intervention. The exenatide and control groups had similar results with respect to ischemia time, demographic characteristics, and ejection fraction before primary percutaneous coronary intervention. The releases of creatine kinase-MB and troponin I were significantly reduced in the exenatide group. In 58 patients evaluated with cardiac magnetic resonance, the absolute mass of delayed hyperenhancement was significantly reduced in the exenatide group as compared with the control group (12.8±11.7 versus 26.4±11.6 g; P<0.01). At 6 months, the exenatide group showed a significantly lower value of E/E′ with improved strain parameters. No significant adverse effects of exenatide administration were detected. Conclusions-In Woo et al Myocardial Protection of Exenatide in AMI 2253in patients with STEMI independent of diabetes mellitus and the safety/tolerability of this drug in an acute setting. To establish these issues, we conducted serial assessment of cardiac biomarkers, routine and speckle tracking echocardiography, and cardiac magnetic resonance imaging in patients with STEMI after performing primary percutaneous coronary intervention (pPCI). Materials and MethodsMaterials and Methods are available in the online-only Supplement. Results Patient CharacteristicsBetween September 2009 and August 2011, we assessed eligibility for 127 consecutive patients with STEMI meeting the clinical eligibility criteria (Figure 1). Eleven patients were excluded from the study before randomization as a withdrawal of consent. After randomization, patients with impaired left ventricular (LV) systolic function (n=18), patients with thrombolysis in myocardial infarction flow grade 1, 2 or 3 on angiography (n=40) were also excluded. All remaining 58 patients completed the study protocol by performing the cardiac magnetic resonance study. No patients performed direct stenting, distal protecting devices, or glycoprotein IIb/IIIa administration. Successful PCI with drug-eluting stents was performed in all patients, and complete revascularization was achieved at a rate of 88%. During the 6-month follow-up, n...

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Objective-The purpose of this study was to evaluate whether exenatide administration can prevent impairment in endothelium-dependent vasodilatation induced by ischemia-reperfusion (IR) injury and whether this effect is mediated by K ATP channel opening. Methods and Results-In a double-blind, placebo-controlled, crossover design, 20 volunteers were randomly assigned to 2 groups: subcutaneous exenatide (10 g) or placebo administration. At 30 minutes after the study drug administration, endothelium-dependent flow-mediated dilatation (FMD) of the radial artery was measured before and after IR (15 minutes of ischemia at the level of the brachial artery followed by 15 minutes of reperfusion) injury. Seven days later, both groups were crossed over and received the other treatment (ie, placebo or exenatide) and underwent the same protocol. Pre-IR radial artery diameter, FMD, and baseline radial artery diameter after IR injury were similar between 2 groups (Pϭno significant difference

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