Abstract 2617: The Effect of Edaravone on Plasma Monocyte Chemoattractant Protein-1 Levels in Patients with Acute Myocardial Infarction
Background: Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the pathogenesis of acute coronary syndrome. Several studies suggest that excessive generation of reactive oxygen species enhanced the synthesis of MCP-1, however, the effect of free-radical scavenger on the MCP-1 levels remains to be elucidated. We have recently demonstrated that the administration of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) just before myocardial reperfusion attenuated both enzymatic infarct size and reperfusion arrhythmia in patients with acute myocardial infarction (AMI). We examined the efficacy of edaravone on plasma MCP-1 levels in patients with acute AMI.
Methods: This study was a randomized, placebo-controlled, open-label study of patients with initial AMI admitted to our institution within 6 hours of symptom onset. We examined plasma MCP-1 levels in consecutive 45 patients with AMI (edaravone group n=25; control group n=20). In edaravone group, 30mg edaravone was intravenously infused during coronary angiography immediately. Plasma samples were obtained before reperfusion, then at 24 h and at 3, 5, 7 and 14 days after reperfusion. Cardiac events during the admission were defined as cardiac death, subacute thrombosis and fatal arrhythmia.
Results: The MCP-1 levels were not different between the two groups before reperfusion therapy. The rate of forrester classification II–IV was significantly higher in the edaravone group. In all patients, reperfusion therapy was performed successfully. In edaravone group, MCP-1 levels (pg/ml) tended to be suppressed after reperfusion therapy and the difference was significantly at 3 days after reperfusion (873.2+/-117.5 versus 516.4+/-65.7; mean+/-SEM, P<0.05). Max CK-MB levels were significantly lower in the edaravone group (217.9+/-30.8 versus 114.6+/-21.3, P<0.05). At 14days after reperfusion therapy, MCP-1 levels in the cardiac event group (n=7) were significantly higher than in the non-cardiac event group (4443.9+/-3070.9 versus 1544.3+/-354.9, P<0.05).
Conclusion: In the present study, edaravone suppressed the plasma MCP-1 levels after reperfusion therapy. These results may provide the additional evidences for efficacy of edaravone in the patients with AMI.