TCT-228 Does intracoronary administration of metabolic cytoportector Mexicor during rescue PCI limit reperfusion injury of the myocardium in patients with AMI.

Abstract

Background: To date, endovascular reperfusion is the essential method for the treatment of AMI, however it has some negative aspects, such as reperfusion injury of the myocardium, distal embolism, etc. Intracoronary administration of drugs provides their fast transport to the target organ and can play a decisive role in the improvement of the results of treatment of AMI. Methods: The study comprised 253 patients (average age 56 7 years) with acute occlusion of the proximal or middle segment of the LAD and absent antegrade blood flow (TIMI 0), who underwent successful recanalization of IRA within the first 6 hours after the onset of AMI. Prior to angiography, all patients were randomized into 2 groups. Patients from Group I (n1⁄4126) received intracoronary Mexicor (0,2 g). Patients from Group II (control, n1⁄4127) did not receive. Intracoronary administration was performed through a special microcatheter during 10 min. Blood samples for markers of cardiomyocytes injury (Troponin I, myoglobin) were taken during recanalization of IRA, in 12 and 24 hours after the procedure. Results: In-hospital course of the disease was rather uneventful, 1 patient (0,8%) died in Gr. I and 3 (2,3%) – in Gr. II. Average values of Troponin I at 12 hours after the procedure in Grs. I and II were 311 47 and 632 39 ng/ml, respectively (p 0,05). Baseline clinical indices in both groups were not significantly different. The increase of LV EF in Grs. I and II was 9,2 5,1% and 4,1 8,2%, respectively (p<0,05). We also noted a significantly better dynamics of contractility on infarct-related segments of the LV in Gr.I in comparison with Gr. II (p<0,05) (table 1). Conclusions: Our study suggests that intracoronary administration of metabolic cytoprotector Mexicor Upoin accordance with a special technique limits reperfusion injury of the myocardium and contributes to the preservation of structural and functional integrity of cardiomyocytes after antegrade blood flow restoration in IRA within the first hours after the onset of AMI.