Anti-Inflammatory Treatment With Colchicine in Acute Myocardial Infarction A Pilot Study
Anti-Inflammatory Treatment With Colchicine in Acute Myocardial Infarction A Pilot Study
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DOI：
10.1161/circulationaha.115.017611
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发表时间：
2015-10-13
期刊：
影响因子：
37.8
通讯作者：
Lekakis, John
中科院分区：
文献类型：
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作者：
Deftereos, Spyridon;Giannopoulos, Georgios;Lekakis, John
背景-炎症过程已被确定为 ST 段抬高型心肌梗死中缺血/再灌注有害影响的关键介质。秋水仙碱是一种具有有效抗炎特性的物质，适合心血管疾病患者安全使用。本研究的目的是检验短期秋水仙碱治疗可减少梗塞面积的假设。 方法和结果 - 疼痛发作 12 小时后出现 ST 段抬高型心肌梗塞的患者（接受直接经皮冠状动脉介入治疗）被随机分配至秋水仙碱组或安慰剂组，为期 5 天。主要结果参数是肌酸激酶-心肌脑部分浓度的曲线下面积。一部分患者在发生 ST 段抬高型心肌梗死后 6 至 9 天接受了心脏 MRI 晚期钆增强。纳入了 151 名患者（MRI 子研究中有 60 名患者）。秋水仙碱组肌酸激酶-心肌脑分数曲线下面积为 3144（四分位距 [IQR]，1754-6940）ng.h(-1.)mL(-1)，而对照组为 6184（IQR，4456-6980）ng.h(-1.)mL(-1)（P
Background-Inflammatory processes have been identified as key mediators of the deleterious effects of ischemia/reperfusion in ST-segment-elevation myocardial infarction. Colchicine is a substance with potent anti-inflammatory properties, suitable for safe use in patients with cardiovascular disease. The purpose of this study was to test the hypothesis that a short course of colchicine treatment could lead to reduced infarct size.Methods and Results-Patients presenting with ST-segment-elevation myocardial infarction 12 hours from pain onset (treated with primary percutaneous coronary intervention) were randomly assigned to colchicine or placebo for 5 days. The primary outcome parameter was the area under the curve of creatine kinase-myocardial brain fraction concentration. A subset of patients underwent cardiac MRI with late gadolinium enhancement 6 to 9 days after the index ST-segment-elevation myocardial infarction. One hundred fifty-one patients were included (60 in the MRI substudy). The area under the creatine kinase-myocardial brain fraction curve was 3144 (interquartile range [IQR], 1754-6940) ng.h(-1.)mL(-1) in the colchicine group in comparison with 6184 (IQR, 4456-6980) ng.h(-1.)mL(-1) in controls (P