Intra-Coronary Administration of Tacrolimus Improves Myocardial Perfusion and Left Ventricular Function in Patients with ST-Segment Elevation Myocardial Infarction (COAT-STEMI) Undergoing Primary Percutaneous Coronary Intervention

Background: Ischemia-reperfusion injury following acute ST-segment elevation myocardial infarction (STEMI) is strongly related to inflammation. However, whether intracoronary (IC) tacrolimus, an immunosuppressant, can improve myocardial perfusion is uncertain. <br> Methods: A multicenter double-blin...

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Veröffentlicht in:Acta Cardiologica Sinica 2021-05, Vol.37 (3), p.239-253
Hauptverfasser: Pei-Hsun Sung, Wei-Chun Huang, Ting-Hsing Chao, Cheng-Han Lee, Teng-Yao Yang, Yu-Sheng Lin, Rei-Yeuh Chang, Jun-Ted Chong, Cheng-Hsu Yang, Chieh-Jen Chen, Sheng-Ying Chung, Shu-Kai Hsueh, Chiung-Jen Wu, Hon-Kan Yip
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Zusammenfassung:Background: Ischemia-reperfusion injury following acute ST-segment elevation myocardial infarction (STEMI) is strongly related to inflammation. However, whether intracoronary (IC) tacrolimus, an immunosuppressant, can improve myocardial perfusion is uncertain. <br> Methods: A multicenter double-blind randomized controlled trial was conducted in Taiwan from 2014 to 2017. Among 316 STEMI patients with Killip class 3 undergoing primary percutaneous coronary intervention (PCI), 151 were assigned to the study group treated with IC tacrolimus 2.5 mg to the culprit vessel before first balloon inflation, and the remaining 165 were assigned to the placebo group receiving IC saline only. The primary endpoint was percentage of post-PCI TIMI-3 flow. The primary composite endpoints included achievement of TIMI-3 flow, TIMI-myocardial perfusion (TMP) grade, or 90-min ST-segment resolution (STR). The secondary endpoints were left ventricular ejection fraction (LVEF) and 1-month/1-year major adverse cardio-cerebral vascula
ISSN:1011-6842