• Natalie L Halladin, Sarah Ekeløf Busch, Svend Eggert Jensen, Henrik Steen Hansen, Tomas Zaremba, Jens Aarøe, Jacob Rosenberg, and Ismail Gögenur.
• Department of Surgery, Herlev Hospital, Herlev Ringvej 75, 2730 Herlev, Denmark. nathoel@yahoo.dk.
• Dan Med J. 2014 Feb 1;61(2):A4773.

IntroductionIschaemia-reperfusion injury following acute myocardial infarctions (AMI) is an unavoidable consequence of the primary percutaneous coronary intervention (pPCI) procedure. A pivotal mechanism in ischaemia-reperfusion injury is the production of reactive oxygen species following reperfusion. The endogenous hormone, melatonin, works as an antioxidant and could potentially minimise the ischaemia-reperfusion injury. Given intracoronarily, it enables melatonin to work directly at the site of reperfusion. We wish to test if melatonin, as an antioxidant, can minimise the reperfusion injury following pPCI in patients with AMI.Material And MethodsThe IMPACT trial is a multicentre, randomised, double-blinded, placebo-controlled study. We wish to include 2 × 20 patients with ST-elevation myocardial infarctions undergoing pPCI within six hours from symptom onset. The primary end-point is the Myocardial Salvage Index assessed by cardiovascular magnetic resonance imaging on day 4 (± 1) after pPCI. The secondary end-points are high-sensitivity troponin, creatinekinase myocardial band and clinical events.ConclusionThe aim of the IMPACT trial is to evaluate the effect of melatonin on reperfusion injuries following pPCI. Owing to its relatively non-toxic profile, melatonin is an easily implementable drug in the clinical setting, and melatonin has the potential to reduce morbidity in patients with AMI.FundingThis study received no financial support from the industry.Trial Registrationwww.clinicaltrials.gov, clinical trials identifier: NCT01172171.

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