The role of Glucagon-Like Peptide 1 Loading on periprocedural myocardial infarction During elective PCI (GOLD-PCI study): A randomized, placebo-controlled trial.
Am Heart J
; 215: 41-51, 2019 09.
Article
em En
| MEDLINE
| ID: mdl-31277053
ABSTRACT
BACKGROUND:
The incretin hormone glucagon-like peptide 1 (GLP-1) has been shown to protect against lethal ischemia-reperfusion injury in animal models and against nonlethal ischemia reperfusion injury in humans. Furthermore, GLP-1 receptor agonists have been shown to reduce major adverse cardiovascular and cerebrovascular events (MACCE) in large-scale studies. We sought to investigate whether GLP-1 reduced percutaneous coronary intervention (PCI)-associated myocardial infarction (PMI) during elective PCI.METHODS:
The study was a randomized, double-blind controlled trial in which patients undergoing elective PCI received an intravenous infusion of either GLP-1 at 1.2 pmol/kg/min or matched 0.9% saline placebo before and during the procedure. Randomization was performed in 11 fashion, with stratification for diabetes mellitus. Six-hour cardiac troponin I (cTnI) was measured with a primary end point of PMI defined as rise â«×5 upper limit of normal (280â¯ng/L). Secondary end points included cTnI rise and MACCE at 12 months.RESULTS:
A total of 192 patients were randomized with 152 (79%) male and a mean age of 68.1⯱â¯8.9â¯years. No significant differences in patient demographics were noted between the groups. There was no difference in the rate of PMI between GLP-1 and placebo (9 [9.8%] vs 8 [8.3%], Pâ¯=â¯1.0) or in the secondary end points of difference in median cTnI between groups (9.5 [0-88.5] vs 20 [0-58.5] ng/L, Pâ¯=â¯.25) and MACCE at 12 months (7 [7.3%] vs 9 [9.4%], Pâ¯=â¯.61).CONCLUSIONS:
In this randomized, placebo-controlled trial, GLP-1 did not reduce the low incidence of PMI or abrogate biomarker rise during elective PCI, nor did it influence the 12-month MACCE rate which also remained low. CLINICAL TRIAL REGISTRATION Clinicaltrials.gov Number NCT02127996https//clinicaltrials.gov/ct2/show/NCT02127996.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fragmentos de Peptídeos
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Traumatismo por Reperfusão Miocárdica
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Procedimentos Cirúrgicos Eletivos
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Peptídeo 1 Semelhante ao Glucagon
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Intervenção Coronária Percutânea
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Infarto do Miocárdio
Tipo de estudo:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
Idioma:
En
Revista:
Am Heart J
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Reino Unido