Does early short-term doxycycline therapy reduce adverse left ventricular remodelling in patients with acute STEMI and LV dysfunction?
Early short-term doxycycline therapy added to standard care significantly reduces adverse left ventricular remodeling and infarct severity in patients with acute STEMI and LV dysfunction following primary PCI.
AIMS: Experimental studies suggest that doxycycline attenuates post-infarction remodelling and exerts protective effects on myocardial ischaemia/reperfusion injury. However, the effects of the drug in the clinical setting are unknown. The aim of this study was to examine the effect of doxycycline on left ventricular (LV) remodelling in patients with acute ST-segment elevation myocardial infarction (STEMI) and LV dysfunction. METHODS AND RESULTS: Open-label, randomized, phase II trial. Immediately after primary percutaneous coronary intervention, patients with STEMI and LV ejection fraction 50% compared with the standard therapy (statistical power > 80% with a type I error = 0.05). The 6-month changes in %LVEDVi were significant smaller in the doxycycline group than in the control group 0.4% (IQR: -16.0 to 14.2%) vs.13.4% (IQR: -7.9 to 29.3%); P = 0.012, as well as infarct size 5.5% (IQR: 0 to 18.8%) vs. 10.4% (IQR: 0.3 to 29.9%) P = 0.052, and infarct severity 0.53 (IQR: 0.43-0.62) vs. 0.44 (IQR: 0.29-0.60), P = 0.014, respectively. CONCLUSION: In patients with acute STEMI and LV dysfunction, doxycycline reduces the adverse LV remodelling for comparable definite myocardial infarct size (NCT00469261).
“Este estudio revela que en pacientes que sufren un primer STEMI acompañado de un cuadro de disfunción VI tratado mediante una PCI primaria, un tratamiento adecuado y en el momento oportuno a corto plazo con doxiciclina reduce, notablemente, el remodelado VI”
Cerisano et al. (Tue,) studied this question.