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J. Am. Coll. Cardiol. · Mar 2010
Clinical TrialEffect of cyclosporine on left ventricular remodeling after reperfused myocardial infarction.
- Nathan Mewton, Pierre Croisille, Gerald Gahide, Gilles Rioufol, Eric Bonnefoy, Ingrid Sanchez, Thien Tri Cung, Catherine Sportouch, Denis Angoulvant, Gérard Finet, Xavier André-Fouët, Geneviève Derumeaux, Christophe Piot, Hélène Vernhet, Didier Revel, and Michel Ovize.
- Hospices Civils de Lyon, Université Claude Bernard Lyon, Lyon, France.
- J. Am. Coll. Cardiol. 2010 Mar 23;55(12):1200-5.
ObjectivesThis study examined the effect of a single dose of cyclosporine administered at the time of reperfusion on left ventricular (LV) remodeling and function by cardiac magnetic resonance 5 days and 6 months after myocardial infarction.BackgroundIn a human study, administration of cyclosporine at the time of acute reperfusion was associated with a smaller infarct size.MethodsTwenty-eight patients of the original cyclosporine study had an acute (at 5 days) and a follow-up (at 6 months) cardiac magnetic resonance study to determine LV volumes, mass, ejection fraction, myocardial wall thickness in infarcted and remote noninfarcted myocardium, and infarct size.ResultsThere was a persistent reduction in infarct size at 6 months in the cyclosporine group compared with the control group of patients (29 +/- 15 g vs. 38 +/- 14 g; p = 0.04). There was a significant reduction of LV end-systolic volume (and a trend for LV end-diastolic volume; p = 0.07) in the cyclosporine group compared with the control group, both at 5 days and 6 months after infarction. There was no significant difference between the 2 groups in either global LV mass or regional wall thickness of the remote noninfarcted myocardium at 5 days or 6 months. Attenuation of LV dilation and improvement of LV ejection fraction by cyclosporine at 6 months were correlated with infarct size reduction.ConclusionsCyclosporine used at the moment of acute myocardial infarction reperfusion persistently reduces infarct size and does not have a detrimental effect on LV remodeling. These results are preliminary and must be supported by further studies. (Ciclosporin A and Acute Myocardial Infarction; NCT00403728).Copyright (c) 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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