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- Title
Effects of a novel ascorbate-based protocol on infarct size and ventricle function in acute myocardial infarction patients undergoing percutaneous coronary angioplasty.
- Authors
Ramos, Cristóbal; Brito, Roberto; González-Montero, Jaime; Valls, Nicolás; Gormaz, Juan G.; Prieto, Juan C.; Aguayo, Rubén; Puentes, Ángel; Noriega, Viviana; Pereira, Gonzalo; Palavecino, Tamara; Rodrigo, Ramón
- Abstract
<bold>Introduction: </bold>This study was designed to test the hypothesis that high-dose ascorbate prior to reperfusion followed by low chronic oral doses ameliorate myocardial reperfusion injury (MRI) in acute myocardial infarction patients subjected to primary percutaneous coronary angioplasty (PCA).<bold>Material and Methods: </bold>A randomized double-blind placebo-controlled and multicenter clinical trial was performed on acute myocardial infarction (AMI) patients who underwent PCA. Sodium ascorbate (320 mmol/l, n = 53) or placebo (n = 46) was infused 30 min prior to PCA. Blood samples were drawn at enrolment (M1), after balloon deflation (M2), 6-8 h after M2 (M3) and at discharge (M4). Total antioxidant capacity of plasma (ferric reducing ability of plasma - FRAP), erythrocyte reduced glutathione (GSH) and plasma ascorbate levels were determined in blood samples. Cardiac magnetic resonance (CMR) was performed at 7-15 days and 2-3 months following PCA. Ninety-nine patients were enrolled. In 67 patients, the first CMR was performed, and 40 patients completed follow-up.<bold>Results: </bold>The ascorbate group showed significantly higher ascorbate and FRAP levels and a decrease in the GSH levels at M2 and M3 (p < 0.05). There were no significant differences in the infarct size, indexed end-systolic volume and ejection fraction at both CMRs. There was a significant amelioration in the decreased ejection fraction between the first and second CMR in the ascorbate group (p < 0.05).<bold>Conclusions: </bold>Ascorbate given prior to reperfusion did not show a significant difference in infarct size or ejection fraction. However, it improved the change in ejection fraction determined between 7-15 days and 2-3 months. This result hints at a possible functional effect of ascorbate to ameliorate MRI.
- Subjects
MYOCARDIAL infarction treatment; MYOCARDIAL reperfusion; PERCUTANEOUS coronary intervention; ANGIOPLASTY; OXIDATIVE stress
- Publication
Archives of Medical Science, 2017, Vol 13, Issue 3, p558
- ISSN
1734-1922
- Publication type
journal article
- DOI
10.5114/aoms.2016.59713