Article ; Online: Mangafodipir as a cardioprotective adjunct to reperfusion therapy: a feasibility study in patients with ST-segment elevation myocardial infarction.
European heart journal. Cardiovascular pharmacotherapy
2015 Volume 1, Issue 1, Page(s) 39–45
Abstract: Aims: The aim of the present study was to examine the feasibility of applying the catalytic antioxidant mangafodipir [MnDPDP, manganese (Mn) dipyridoxyl diphosphate] as a cardioprotective adjunct to primary percutaneous coronary intervention (pPCI) in ... ...
| Abstract | Aims: The aim of the present study was to examine the feasibility of applying the catalytic antioxidant mangafodipir [MnDPDP, manganese (Mn) dipyridoxyl diphosphate] as a cardioprotective adjunct to primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation (STE) myocardial infarction (STEMI). Both MnDPDP and a metabolite (Mn dipyridoxyl ethyldiamine) possess properties as mitochondrial superoxide dismutase mimetics and iron chelators, and combat oxidative stress in various tissues and conditions. Methods and results: The study tested MnDPDP (n = 10) vs. saline placebo (n = 10), given as a brief intravenous (i.v.) infusion prior to balloon inflation during pPCI in patients with STEMI. Mangafodipir was well tolerated and did not affect heart rate or blood pressure. Despite longer ischaemic time (205 vs. 144 min, P = 0.019) in the MnDPDP group, plasma biomarker releases were identical for the two groups. With placebo vs. MnDPDP, mean STE resolutions were 69.8 vs. 81.9% (P = 0.224) at 6 h and 73.1 vs. 84.3% (P = 0.077) at 48 h. Cardiac magnetic resonance revealed mean infarct sizes of 32.5 vs. 26.2% (P = 0.406) and mean left ventricular (LV) ejection fractions of 41.8 vs. 47.7% (P = 0.617) with placebo vs. MnDPDP. More LV thrombi were detected in placebo hearts (5 of 8) than MnDPDP-treated hearts (1 of 10; P = 0.011). Conclusions: Mangafodipir is a safe drug for use as an adjunct to reperfusion therapy. A tendency to benefit of MnDPDP needs confirmation in a larger population. The study revealed important information for the design of a Phase II trial. |
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| MeSH term(s) | Dose-Response Relationship, Drug ; Edetic Acid/administration & dosage ; Edetic Acid/analogs & derivatives ; Feasibility Studies ; Female ; Follow-Up Studies ; Heart Ventricles/diagnostic imaging ; Heart Ventricles/physiopathology ; Humans ; Infusions, Intravenous ; Magnetic Resonance Imaging, Cine ; Male ; Middle Aged ; Percutaneous Coronary Intervention/methods ; Pyridoxal Phosphate/administration & dosage ; Pyridoxal Phosphate/analogs & derivatives ; Retrospective Studies ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/drug therapy ; ST Elevation Myocardial Infarction/surgery ; Treatment Outcome ; Ventricular Function, Left/physiology |
| Chemical Substances | Pyridoxal Phosphate (5V5IOJ8338) ; Edetic Acid (9G34HU7RV0) ; N,N'-bis(pyridoxal-5-phosphate)ethylenediamine-N,N'-diacetic acid (P28BIW0UTB) |
| Language | English |
| Publishing date | 2015 |
| Publishing country | England |
| Document type | Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 2808613-2 |
| ISSN | 2055-6845 ; 2055-6837 |
| ISSN (online) | 2055-6845 |
| ISSN | 2055-6837 |
| DOI | 10.1093/ehjcvp/pvu021 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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