Intravenous Interferon-ß1a for the Treatment of Ischemia-Reperfusion Injury in Acute Myocardial Infarct in Pigs.

BACKGROUND: To investigate the potential of intravenously administered porcine recombinant interferon-ß1a (IFN-ß1a) for myocardial protection during acute ischemia-reperfusion (IR) injury in an experimental animal model. METHODS: Twenty-two piglets (mean ± standard deviation, 26.7 ± 1.65 kg) were assigned to either the IFN group (n = 12) or the control group (n = 10). IR injury was induced by occluding the distal left descending coronary artery for 30 minutes, with a reperfusion period of 6 h. In the IFN group, the animals received 12.5 µg IFN-ß1a intravenously repeatedly; the control group received saline solution. The levels of interleukin-6 (IL-6) and cardiac troponin I (TnI) were measured, and the amount of myocardial damage was quantified by analyzing myocardial apoptosis and the mean fluorescence intensity (MFI) of methylene blue-stained cardiac tissue. RESULTS: In the IFN group, significantly more premature deaths occurred compared with the control group (25% versus 17%, P = .013). Between the groups, the mean heart rate was higher in the IFN group (102 ± 22 versus 80 ± 20 beats per minute, P = .02). IL-6 and TnI levels were comparable between the groups, with no significant difference, and there was no difference between the study groups in myocardial apoptosis in the infarcted myocardium. The percentage of MFI differed significantly between the IFN and control groups (90.75% ± 4.90% versus 96.02% ± 2.73%, P = .01). CONCLUSION: In this acute IR injury animal model, IFN-ß1a did not protect the myocardium from IR injury, but rather increased some of the unfavorable outcomes studied.

A 6-Year Single-Center Experience of Intra-aortic Balloon Pump Treatment--Retrospective Analysis of 223 Patients.

OBJECTIVES: This study describes the long-term survival (1 year) of patients after intra-aortic balloon pump (IAPB) treatment. DESIGN: A single-center, retrospective registry study. SETTING: Single university hospital intensive care unit. PARTICIPANTS: Participants included 223 consecutive patients who received intra-aortic balloon pump (IABP) treatment between January 1, 2005, and December 31, 2010 (203 cardiac surgical patients [7.8% of all cardiac surgical patients] and 20 conservative medical patients). INTERVENTIONS: IABP treatment was used as an adjunct therapy for severe hemodynamic compromise perioperatively in cardiac surgery and in hemodynamic shock of other etiology. MEASUREMENTS AND MAIN RESULTS: Mean age of patients was 66±10 years. The 30-day mortality was 22.1% for surgical patients and 37.8% for conservative medical patients. The 1-year mortality was 24.5% for surgical patients and 55% for conservative medical patients. There were 14 (6.3%) major complications related to IABP treatment that required operative treatment. The 1-year survival for patients surviving the initial 30 days after coronary artery bypass grafting was 95.2%. Independent predictors of 1-year mortality (Cox regression) were age, previous cardiac surgery, critical preoperative state, and conservative medical treatment. Timing (preoperative, intraoperative, postoperative) of IABP treatment did not predict survival. CONCLUSIONS: IABP treatment was safe with few serious complications. Timing of IABP placement was not related to survival. Survival at 1-year follow-up was excellent after an initially high mortality for cardiac surgical patients treated for hemodynamic compromise with aortic counterpulsation.