Purpose: The study of cardioprotective action of intracoronary metabolic cytoprotector Mexicor (methylethylpiridinol succinate), after recanalization of IRA in STEMI patients.
Material and Methods: 253 patients (average age - 56±7 years) with total acute occlusion of the LAD underwent successful recanalization of IRA within the first 6 hours after the onset of AMI. All patients were randomized into 2 groups. Group I (n=126) received intracoronary Mexicor (0,2 g). Group II (control, n=127) did not receive intracoronary cytoprotector. Baseline clinical, historical and angiographic data were not significantly different in the studied groups. Blood samples for markers of cardiomyocytes injury (Troponin I, myoglobin) were taken during recanalization of IRA, in 12 and 24 hours after the procedure.
Results: In-hospital course of the disease was rather uneventful, 1 patient (0,8%) died in Gr. I and 3 (2,3%) – in Gr. II. Average values of Troponin I at 12 hours after the procedure in Grs. I and II were 311±47 and 632±39 ng/ml, respectively (p<0,05). In the long-term after the procedure, in average – in 6,8±0,7 months, the survival in Gr. I was 96,8%, in Gr. II - 87,6% (p>0,05). Baseline clinical indices in both groups were not significantly different. The increase of LV EF in Grs. I and II was 9,2±5,1% and 4,1±8,2%, respectively (p<0,05). We also noted a significantly better dynamics of contractility on infarct-related segments of the LV in Gr.I in comparison with Gr. II.
Conclusion: Our study suggests that intracoronary administration of metabolic cytoprotector Mexicor limits reperfusion injury of the myocardium and contributes to the preservation of structural and functional integrity of cardiomyocytes after antegrade blood flow restoration in IRA within the first hours after the onset of AMI.
