Abstract 12206: Cardioprotective Effects of Exenatide in Patients with ST-segment Elevation Myocardial Infarction undergoing Primary Percutaneous Coronary Intervention; Results of Exenatide on Myocardial Protection in primary REvascularization (EMPIRE) Study
Background- Experimental evidence suggests exenatide, a glucagon-like peptide 1 receptor analogue, has significant cardiovascular protective effects in various conditions. We examined whether conventional use of exenatide at the time of primary percutaneous coronary intervention (pPCI) would reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI).
Methods and Results- Fifty-eight patients with STEMI and Thrombolysis in Myocardial Infarction (TIMI) flow 0 were enrolled in the study and randomly assigned to receive either exenatide or placebo (saline) subcutaneously. Infarct size was assessed by measuring the release of creatine kinase(CK)-MB and troponin I during 72 hours and by performing cardiac magnetic resonance (CMR) imaging at 1 month after infarction. Conventional and speckle tracking echocardiography was performed at initial presentation and at 3 days and 6 months after pPCI. The exenatide and control groups had similar results with respect to ischemia time, demographic characteristics, and ejection fraction before pPCI. The releases of CK-MB and troponin I were significantly reduced in the exenatide group. At 1 month, the absolute mass of delayed hyperenhancement on CMR was significantly reduced in the exenatide group as compared to the control group (12.8 ± 11.7 g vs 26.4 ± 11.6 g, p < 0.01). At 6 months, the exenatide group showed a significantly lower value of E/E’ with improved strain parameters. No significant adverse effects of exenatide administration were detected.
Conclusions: In patients with STEMI, adjunctive exenatide therapy with pPCI was associated with reduction of infarct size and improvement of subclinical left ventricular function.
- © 2012 by American Heart Association, Inc.