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J Am Coll Cardiol. 2010 Mar 23;55(12):1200-5. doi: 10.1016/j.jacc.2009.10.052.

Effect of cyclosporine on left ventricular remodeling after reperfused myocardial infarction.

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1
Hospices Civils de Lyon, Université Claude Bernard Lyon, Lyon, France.

Abstract

OBJECTIVES:

This study examined the effect of a single dose of cyclosporine administered at the time of reperfusion on left ventricular (LV) remodeling and function by cardiac magnetic resonance 5 days and 6 months after myocardial infarction.

BACKGROUND:

In a human study, administration of cyclosporine at the time of acute reperfusion was associated with a smaller infarct size.

METHODS:

Twenty-eight patients of the original cyclosporine study had an acute (at 5 days) and a follow-up (at 6 months) cardiac magnetic resonance study to determine LV volumes, mass, ejection fraction, myocardial wall thickness in infarcted and remote noninfarcted myocardium, and infarct size.

RESULTS:

There was a persistent reduction in infarct size at 6 months in the cyclosporine group compared with the control group of patients (29 +/- 15 g vs. 38 +/- 14 g; p = 0.04). There was a significant reduction of LV end-systolic volume (and a trend for LV end-diastolic volume; p = 0.07) in the cyclosporine group compared with the control group, both at 5 days and 6 months after infarction. There was no significant difference between the 2 groups in either global LV mass or regional wall thickness of the remote noninfarcted myocardium at 5 days or 6 months. Attenuation of LV dilation and improvement of LV ejection fraction by cyclosporine at 6 months were correlated with infarct size reduction.

CONCLUSIONS:

Cyclosporine used at the moment of acute myocardial infarction reperfusion persistently reduces infarct size and does not have a detrimental effect on LV remodeling. These results are preliminary and must be supported by further studies. (Ciclosporin A and Acute Myocardial Infarction; NCT00403728).

PMID:
20298926
DOI:
10.1016/j.jacc.2009.10.052
[Indexed for MEDLINE]
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