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Adlbrecht, C; Wurm, R; Pezawas, T; Andreas, M; Redwan, B; Distelmaier, K; Kaider, A; Lang, IM.
Effects of endothelin A receptor blockade in patients with ST-elevation acute coronary syndrome - A rhythmologic substudy
LIFE SCI. 2014; 118(2): 430-434. Doi: 10.1016/j.lfs.2014.02.015
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Co-authors Med Uni Graz: Andreas Martin
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Abstract:: Aims: Ventricular arrhythmias are common after acute myocardial infarction (AMI). Endothelin (ET) is a mediator of microvascular dysfunction and cardiac remodeling with arrhythmogenic potential. The aim of this study was to assess safety and feasibility of selective ET-A receptor blockade in ST-elevation acute coronary syndrome (STE-ACS) within a larger randomized trial. Main methods: Patients with posterior-wall STE-ACS were randomly assigned to receive intravenous BQ-123 at 400 nmol/min or placebo over 60 min, starting immediately prior to primary percutaneous coronary intervention. Twenty-four hour Holter recordings were performed during hospitalization for STE-ACS and after 6-8 weeks. The predefined primary endpoint was the documentation of ventricular tachycardia and/or late potentials at follow-up. Key findings: There was no significant difference in the predefined primary endpoint at 45 (33-62) days (0/16 (0%) in BQ-123 treated patients vs. 1/14 (7%) in the placebo group, p = 0.465). At 2 (1-3) days, an increase in the total number of supraventricular extrasystoles (SVES)/24 h in patients randomized to BQ-123 (45 (17-165) beats vs. 11(5-72) beats in placebo treated patients, p = 0.025) occurred. This increase was also observed at 45 days (105 (37-216) beats vs. 11(3-98) beats in placebo treated patients, p = 0.037). There was no significant difference regarding other rhythmologic secondary endpoints between the two groups. Significance: Based on the analysis of long-term ECG data, short-term administration of BQ-123 after AMI was safe. Because of the small sample size, no firm conclusion regarding antiarrhythmic efficacy can be drawn. (C) 2014 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license.
Find related publications in this database (Keywords): Acute myocardial infarction; Endothelin; BQ-123; Percutaneous coronary intervention; Reperfusion; Arrhythmia