Abstract 12036: Title: Improving RBC K-O2 Binding by Amiloride HCl Dihydrate in CHD: A Novel Treatment for Reversion of Angina and ST-T Alterations
Introduction: Following our discovery of K-O2 binding by oxyhemoglobin we tested the hypothesis that increasing erythrocyte K (Ki) by Amiloride HCl Dihydrate (AHD) improves K-O2 binding in CHD.
Aim: to evaluate the novel AHD in patients with angina and ST-T alterations.
Methods: 195 patients (63% males, 59±7 years, central aortic BP 166 ±12/95±9 mmHg) with CHD (angina 73%, MI 49%, 3-vessel disease 66% and HF 48%) were randomized to double-blind trial of AHD (5 mg)+Optimal Medical Therapy (n=104 vs 91 OMT, 1st year), followed by open-label trial of AHD+OMT vs OMT (2nd year). Both phases were intention-to-treat.
Methods: All cases had serial ECG, Ion Transport Laboratory (RBC, plasma and 12-hours overnight urinary electrolytes) and noninvasive central aortic BP and hemodynamic (DynaPulse 200M). SAS statistic analysis, p<0.05 was significant.
Results: 1st Month, compared to OMT, 87% of subjects on AHD had increased Ki (92.1±6 vs 85±5 mmol/lc, p<0.001), reduction in angina class (1.6±0.7 vs 3.1±0.8, p<0.0001), improved ST-T alterations (54%) and HF symptoms (35%) vs less angina (21%), and unchanged ST-T and HF in placebo. At 2-M, in severe HT (n=35) AHD+OMT decreases central aortic BP in 20 patients (158 ± 12/97 ±11 vs 190±14/112±9 mmHg, p<0.0001), but was unchanged in 15 patients on OMT (179 ±11/107 ±9 mmHg, p NS). At 6-M, subjects on AHD had low recurrence of angina (17 vs 46% OMT), while the ST-T was normal in 34%, improved in 43%, and unchanged in 14%, but not improved ST-T was recorded in patients receiving OMT. At 1st year, no cardiovascular events were reported during treatment with AHD and 25 cases (24%) showed R-voltages in areas of previous infarcts, suggesting improved LV function or electrical regeneration of LV. In OMT group significant recurrence of angina (28%) and CV events (12%) were reported. At 2nd year, the trial was halted (Declaration of Helsinki, WMA 2000, Part C) and all subjects received AHD+OMT: Angina was reversed in 87% of 195 subjects, ST-T alteration improved (54%), reversed (31%) or were unchanged (15%). No CV event was reported in the 195 patients enrolled.
Conclusions: This study confirms that AHD improves RBC K-O2 binding by oxyhemoglobin, and rapidly reverses angina, ST-T alterations and induces electrical regeneration of the LV in older infarcts.
- Coronary Heart Diseases
- K-O2 binding by oxyhemoglobin
- Amiloride HCl Dihydrate
- Reversion of angina
- Reversion of ST-T alterations
Author Disclosures: C. Delgado: None. A. Delgado-Leon: None. A. Delgado-Almeida: None.
- © 2015 by American Heart Association, Inc.