Effect of Cyclosporine on Reperfusion Injury in Acute Myocardial Infarction

Piot, Christophe; Croisille, Pierre; Staat, Patrick; Thibault, Hélène; Rioufol, Gilles; Mewton, Nathan; Elbelghiti, Rachid; Cung, Thien Tri; Bonnefoy, Éric; Angoulvant, Denis; Macia, Christophe; Raczka, F.; Sportouch, Catherine; Gahide, G.; Finet, Gérard; André‐Fouët, Xavier; Revel, D.; Kirkorian, Gilbert; Monassier, Jean‐Pierre; Dérumeaux, Geneviève; Ovize, Michel

doi:10.1056/nejmoa071142

Cited by 1,161 publications

(899 citation statements)

References 44 publications

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“…Further, patients with larger infarcts or those with an anterior MI are more likely to benefit from such an intervention. 5,6,27,32 Indeed, in our initial study, there was a trend toward a stronger effect of sevoflurane in patients with an anterior MI on assessing myocardial injury by release of cardiac enzymes. 20 In the current study, we did not observe an overall clinically meaningful effect of sevoflurane on the long-term assessment of LV function, myocardial scarring, or hibernating myocardium.…”

Section: Discussionmentioning

confidence: 80%

“…Further, due to the nature of our trial and its complexity and in accordance with the Systolic blood pressure-mmHg 144 (27) 150 (32) Heart rate-beatsÁmin -1 78 (13) 76 (18) First contact to 1 st device-min 78 (23) 79 (22) Creatinine baseline-lMolÁL -1 80 (22) 81 (22) Data represent mean (SD) or number (%)…”

Section: Discussionmentioning

confidence: 99%

“…The SIAMI study was originally powered for a 35% reduction in infarct size as assessed by measurement of the area under the curve of creatine kinase, which is similar to other initial studies of ischemic or pharmacological conditioning. 20,26,27 With a statistical power of 80% and a type I error of 0.05 using a two-sided test, we needed to enrol 50 patients. The sample size calculation was performed for the primary outcomes, which were reported previously, and not for the secondary outcomes that are reported here.…”

Section: Echocardiography Assessmentmentioning

confidence: 99%

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One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient's arrival for cardiac catheterization, the anesthesia team administered sevoflurane or oxygen for 30 min using a tight-fitting mask.In this substudy, we report the one-year outcomes. Patients were followed clinically for one year; they underwent a thallium cardiac viability study at six months and an echocardiogram at one year. Results Forty-six patients completed follow-up. One patient in the sevoflurane group died. The mean [standard deviation (SD)] ejection fraction by singlephoton emission computed tomography at six months was 51.7 (7.7)% in the sevoflurane group and 51 (9.1)% in the control group (mean difference, 0.7%; 95% confidence interval [CI], -5.9 to 7.3; P = 0.831). The median [interquartile range] amount of scarring at six months was 0% [0 -8] in the sevoflurane group and 2.5% [0 -7.1] in control group (mean difference, -0.1%; 95% CI, -4.6 to 4.4; P = 0.700). The mean (SD) percentage of hibernating myocardium was similar in both groups 0% [0, 5] (mean difference, -1.3%; 95% CI, -3.4 to 0.9; P = 0.259). The mean (SD) ejection fraction at one year increased compared with baseline by 8.0 (9.1)% (P \ 0.001).Conclusions In this study, we did not find an effect of sevoflurane on left ventricular function or myocardial injury at one year post STEMI. This trial was registered at www.clinicaltrials.gov; identifier: NCT00971607. RésuméContexte Le sévoflurane est un anesthésique inhalé qui a des effets cardioprotecteurs. On ne dispose que de peu Meeting presentation: Presented in part at the Canadian Cardiovascular Congress in Vancouver, 2014 and published as an abstract (Can J Cardiol 2014, 30 (10): s62.).

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Echocardiography Assessmentmentioning

confidence: 99%

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One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Lavi

Alemayehu

McCarty

et al. 2015

Can J Anesth/J Can Anesth

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“…More importantly, cyclosporine A had also been reported to improve the heart function in human. Serum creatine kinase and infarct size were decreased in the cyclosporine A‐treated patients with acute myocardial infarction 79. Ca 2+ overload was the trigger of both MPTP opening and heart failure.…”

Section: Necrosis In Heart Diseasesmentioning

confidence: 96%

Molecular mechanism and therapy application of necrosis during myocardial injury

Ding

Tariq

et al. 2018

J Cellular Molecular Medi

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Necrosis is an ancient topic which gains new attraction in the research area these years. There is no doubt that some necrosis can be regulated by genetic manipulation other than an accidental cell death resulting from physical or chemical stimuli. Recent advances in the molecular mechanism underlying the programmed necrosis show a fine regulation network which indicates new therapy targets in human diseases. Heart diseases seriously endanger our health and have high fatality rates in the patients. Cell death of cardiac myocytes is believed to be critical in the pathogenesis of heart diseases. Although necrosis is likely to play a more important role in cardiac cell death than apoptosis, apoptosis has been paid much attention in the past 30 years because it used to be considered as the only form of programmed cell death. However, recent findings of programmed necrosis and the related signalling pathways have broadened our horizon in the field of programmed cell death and promote new pharmacological application in the treatment of heart diseases. In this review, we summarize the advanced progress in these signalling pathways and discuss the pathos‐physiological relevance and therapeutic implication of targeting necrosis in heart diseases treatment.

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“…More recently, it has been shown that administration of a single bolus of cyclosporin A, an inhibitor of mPTP opening, at the time of reperfusion was associated with a smaller infarct size in patients with AMI. 19 …”

Section: Mitochondria As the End Effectorsmentioning

confidence: 99%

Postconditioning against ischaemia-reperfusion injury: ready for wide application in patients?

Yetgin¹,

Manintveld²,

Duncker³

et al. 2010

NHJL

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389 ICIN The Netherlands Heart Institute I n t e r u n i v e r s i t y C a r d i o l o g y I n s t i t u t e o f t h e N e t h e r l a n d sIschaemic postconditioning (IPOC) is an intervention in which brief, intermittent periods of reocclusion at the onset of reperfusion (i.e. stuttering reperfusion) protect myocardium from lethal reperfusion injury. The mechanism underlying the cardioprotective effects of IPOC is incompletely understood. However, it is perceived that IPOC begins with specific cellsurface receptors responsible for activating a number of signalling pathways, many of which appear to converge at the mitochondrial level. IPOC has been demonstrated both in animal models and in patients with acute myocardial infarction (AMI) in small proof-ofconcept trials. This intervention offers the possibility of further limiting infarct size in patients undergoing primary percutaneous coronary intervention (PCI). Here, we provide a brief overview of the concept of IPOC and the mechanisms underlying this phenomenon. (Neth Heart J 2010;18:389-92.)

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Effect of Cyclosporine on Reperfusion Injury in Acute Myocardial Infarction

Abstract: In our small, pilot trial, administration of cyclosporine at the time of reperfusion was associated with a smaller infarct by some measures than that seen with placebo. These data are preliminary and require confirmation in a larger clinical trial.

Cited by 1,161 publications

References 44 publications

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial

Molecular mechanism and therapy application of necrosis during myocardial injury

Postconditioning against ischaemia-reperfusion injury: ready for wide application in patients?

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