Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment Elevation Myocardial Infarction
Effects of Liraglutide on Reperfusion Injury in Patients With ST-Segment Elevation Myocardial Infarction
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DOI：
10.1161/circimaging.116.005146
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发表时间：
2016-12-01
影响因子：
7.5
通讯作者：
Gu, Xiao Fang
中科院分区：
文献类型：
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作者：
Chen, Wei Ren;Chen, Yun Dai;Gu, Xiao Fang
背景：利拉鲁肽是一种胰升糖素样肽-1类似物，据报道可以减轻小鼠的再灌注损伤。我们计划评价利拉鲁肽对急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗患者再灌注损伤的影响。方法与结果96例急诊经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者随机分为皮下注射利拉鲁肽和安慰剂两组。干预前30分钟开始研究治疗(1.8 mg)，术后维持7天(0.6 mg治疗2天，1.2 mg治疗2天，然后1.8 mg治疗3天)。挽救指数由指数入院时(35+/-12小时)测量的危险心肌面积和首次经皮冠状动脉介入治疗后91+/-5天心脏磁共振测量的最终心肌梗死面积计算。在心脏磁共振评估的77名患者中，在主要终点3个月时，利拉鲁肽组的挽救指数高于安慰剂组(0.66+/-0.14vs0.55+/-0.15；P=0.001)。利拉鲁肽组的最终梗塞面积小于安慰剂组(15+/-12g比21+/-15g；P=0.05)。利拉鲁肽组血清超敏C反应蛋白水平低于对照组(P
Background Liraglutide, a glucagon-like peptide-1 analog, was reported to reduce reperfusion injury in mice. We planned to evaluate the effects of liraglutide on reperfusion injury in patients with acute ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention.Methods and Results A total of 96 patients with ST-segment elevation myocardial infarction undergoing emergency primary percutaneous coronary intervention were randomized to receive either subcutaneous liraglutide or placebo. Study treatment was commenced 30 minutes before intervention (1.8 mg) and maintained for 7 days after the procedure (0.6 mg for 2 days, 1.2 mg for 2 days, followed by 1.8 mg for 3 days). The salvage index was calculated from myocardial area at risk, measured during the index admission (35 +/- 12 hours), and final infarct size measured at 91 +/- 5 days after primary percutaneous coronary intervention by cardiac magnetic resonance. At 3 months, the primary end point, a higher salvage index was found in the liraglutide group than in the placebo group in 77 patients evaluated with cardiac magnetic resonance (0.66 +/- 0.14 versus 0.55 +/- 0.15; P=0.001). The final infarct size was lower in the liraglutide group than that in the placebo group (15 +/- 12 versus 21 +/- 15 g; P=0.05). Serum high-sensitivity C-reactive protein level was lower in the liraglutide group (P