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Cyclosporine May Reduce Size of Infarct After Heart Attack

Researchers suggest using cyclosporine just before percutaneous coronary intervention

WEDNESDAY, July 30 (HealthDay News) -- The use of cyclosporine immediately before percutaneous coronary intervention in patients with myocardial infarction may be associated with a smaller infarct, according to research from the July 31 New England Journal of Medicine.

Christophe Piot, M.D., Ph.D., of the Hopital Arnaud de Villeneuve in Montpellier, France, and colleagues analyzed data from a small pilot study in which 58 patients who presented with acute ST-elevation myocardial infarction were randomized to receive a bolus of 2.5 milligrams of cyclosporine per kilogram of body weight or saline placebo after coronary angiography but before stenting.

The release of creatine kinase, but not troponin I, was significantly reduced in the cyclosporine group. In a subgroup of patients assessed with magnetic resonance imaging, the absolute mass of the area of hyperenhancement -- representing infarcted tissue -- was significantly reduced in the treatment group.

These findings "confirm the existence of myocardial reperfusion injury in humans and suggest that the mitochondrial permeability-transition pore is a new target for protecting the heart against this form of injury and reducing the size of the myocardial infarct in patients who are undergoing primary PCI (percutaneous coronary intervention)," write Derek J. Hausenloy, M.D., Ph.D., and Derek M. Yellon, Ph.D., in an accompanying editorial. " We believe it is now time to take myocardial reperfusion injury seriously."

A co-author of the study disclosed a financial relationship with Novartis, and Yellon disclosed financial ties to several pharmaceutical companies.

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