Ciclosporin A and Acute Myocardial Infarction

Hospices Civils de Lyon60 enrolled

Overview

Beyond its immunosuppressive properties, ciclosporine A (CsA) can also inhibit the opening of a mitochondrial mega-channel called the permeability transition pore (mPTP). Opening of the mPTP plays a key role in cardiomyocyte death during reperfusion following a prolonged ischemic insult. Ciclosporin A has been shown to reduce infarct size when administered at reperfusion in experimental models. The objective of the present study is to determine whether administration of CsA at reperfusion in patients with ongoing acute myocardial infarction treated by coronary angioplasty might reduce infarct size.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Myocardial Infarction

Interventions

ciclosporine ADRUG

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Male and female patients, aged more than 18, with suspected first acute myocardial infarction * Within 12 hours of the onset of chest pain * With a need for emergency revascularization by angioplasty. Patients must display a fully occluded (TIMI zero flow) culprit coronary artery, absence of visible collaterals and exhibit TIMI flow \>2 after direct stenting by angioplasty. Exclusion Criteria: * Hypersensibility to ciclosporine A * Cardiac arrest or cardiogenic shock * Immunosuppressive disease (\< 6 months): cancers, lymphomas, positive serology for HIV, hepatitis, etc. * Known renal failure or serum creatinine \> 120 µmole/l at admission * Liver failure * Uncontrolled hypertension * Current pregnancy or women without contraception

Locations (1)

Michel Ovize

Lyon, France

Outcomes

Primary Outcomes

Infarct size evaluated primarily by the area under the curve of CK and troponin I release over the first 72 hours of reperfusion.

Secondary Outcomes

Myocardial contractile reserve assessed by dobutamine echocardiography at day 5.

No reflow evaluated by MRI at day 5

Recovery of myocardial contraction assessed by echocardiography and MRI at month 3

Data from ClinicalTrials.gov

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