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J Cardiovasc Transl Res. 2017 Dec;10(5-6):470-479. doi: 10.1007/s12265-017-9768-7. Epub 2017 Oct 12.

Effect of Intracoronary and Intravenous Melatonin on Myocardial Salvage Index in Patients with ST-Elevation Myocardial Infarction: a Randomized Placebo Controlled Trial.

Author information

1
Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark. savb@regionsjaelland.dk.
2
Center for Perioperative Optimization, Department of Surgery, Herlev University Hospital, Herlev Ringvej 75, 2730, Herlev, Denmark.
3
Department of Cardiology, Aalborg University Hospital, Hobrovej 18-22, 9100, Aalborg, Denmark.
4
Department of Medical Biochemistry, Stavanger University Hospital, PB 8100, 4068, Stavanger, Norway.
5
Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, 2200, Copenhagen, Denmark.
6
Center for Surgical Science, Department of Surgery, Zealand University Hospital, Lykkebaekvej 1, 4600, Koege, Denmark.

Abstract

Melatonin has attenuated myocardial ischemia reperfusion injury in experimental studies. We hypothesized that the administration of melatonin during acute myocardial reperfusion improves myocardial salvage index in patients with ST-elevation myocardial infarction. Patients (n = 48) were randomized in a 1:1 ratio to intracoronary and intravenous melatonin (total 50 mg) or placebo. The myocardial salvage index assessed by cardiac magnetic resonance imaging at day 4 (± 1 day) after primary percutaneous coronary intervention was similar in the melatonin group (n = 22) at 55.3% (95% CI 47.0-63.6) and the placebo group (n = 19) at 61.5% (95% CI 57.5-65.5), p = 0.21. The levels of high-sensitive troponin T, creatinine kinase myocardial band, and oxidative biomarkers (advanced oxidation protein products, malondialdehyde, myeloperoxidase) were similar in the groups. The frequency of clinical events at 90 days did not differ between the groups. In conclusion, melatonin did not improve the myocardial salvage index after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction compared with placebo.

KEYWORDS:

Acute myocardial infarction; Ischemic heart disease; Melatonin; Myocardial reperfusion injury; Primary percutaneous coronary intervention

PMID:
29027116
DOI:
10.1007/s12265-017-9768-7
[Indexed for MEDLINE]

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