Effect of Caldaret on the Incidence of Severe Left Ventricular Dysfunction in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Coronary Intervention

• Published in: The American journal of cardiology 2009, Vol.103 (1), p.1-4
• Main Authors: Tzivoni, Dan, MD, Balkin, Jonathan, MD, Bär, Frits W., MD, Hibberd, Mark, MD, Reiber, Johan H.C., MD, Cowing, Graham, PhD
• Format: Article
• Language: English
• Subjects: Angioplasty, Balloon, Coronary - methods; Benzenesulfonates - administration & dosage; Benzenesulfonates - therapeutic use; Biological and medical sciences; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular system; Cells; Coronary heart disease; Dose-Response Relationship, Drug; Drugs; Electrocardiography; Female; Follow-Up Studies; Heart; Heart attacks; Heart failure, cardiogenic pulmonary edema, cardiac enlargement; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Incidence; Injections, Intravenous; Male; Medical sciences; Medical treatment; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - physiopathology; Myocardial Infarction - therapy; Myocarditis. Cardiomyopathies; Piperazines - administration & dosage; Piperazines - therapeutic use; Stroke Volume - drug effects; Tomography, Emission-Computed, Single-Photon; Treatment Outcome; Ventricular Dysfunction, Left - drug therapy; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - etiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2008.08.047

Primary percutaneous coronary intervention (PCI) decreases myocardial damage in patients with ST-elevation myocardial infarction (STEMI). Cellular reperfusion injury associated with calcium overload may limit myocardial salvage. We previously showed (CASTEMI trial) that caldaret (MCC-135), which modulates myocardial calcium handling when administered before PCI in patients with STEMI, did not change residual left ventricular (LV) function. The aim of this subanalysis was to examine whether caldaret decreases the incidence of LV dysfunction (LV ejection fraction ≤30%) in patients with STEMI undergoing primary PCI. Of 387 patients enrolled in the CASTEMI study, 239 had single-photon emission computed tomographic data on days 7 and 30 after the infarct. The incidence of LV dysfunction in patients receiving low- and high-dose caldaret was compared with placebo. At day 30 after the infarct, there was a significant decrease in the incidence of LV dysfunction in patients receiving low and high doses of caldaret versus placebo (8.0%, 6.9% vs 17.5%, p