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Post-MI Outcome No Better with Remodeling Inhibitor

Patients were randomized to matrix metalloproteinase inhibitor PG-116800

WEDNESDAY, July 12 (HealthDay News) -- The matrix metalloproteinase (MMP) inhibitor PG-116800 does not prevent left ventricular remodeling after myocardial infarction, according to results from the Prevention of Myocardial Infarction Early Remodeling, or PREMIER trial, published in the July 4 issue of the Journal of the American College of Cardiology. PG-116800 has shown significant antiremodeling effects in animal models of myocardial infarction and ischemic heart failure.

W. Douglas Weaver, M.D., from Henry Ford Hospital in Detroit, and PREMIER trial members conducted a double-blind, placebo-controlled study to test whether PG-116800 could prevent left ventricular remodeling in 253 patients with a recent ST-segment elevation myocardial infarction and low (15 percent to 40 percent) ejection fraction.

Patients randomized to either PG-116800 or placebo for 90 days showed no difference in left ventricular end-diastolic volume index measured by echocardiography (5.09 versus 5.48 mL per meter-squared, respectively). There were also no differences in the rates of death or reinfarction.

"Contrary to animal and preclinical data, our disappointing results cast doubt on whether MMP inhibition might ameliorate post-myocardial infarction remodeling," the authors write. "Selective MMP inhibition with PG-116800 is ineffective for treating this condition, yet our current understanding of which MMP(s) contribute most to ventricular remodeling is rudimentary."

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