What does this research mean for the field?

Pharmacological doses of hydrocortisone prevent myocardial cells from progressing to ischemic necrosis and significantly reduce infarct size following acute coronary occlusion, even when administration is delayed up to 6 hours. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

March 1, 1973Journal of Clinical InvestigationOpen Access

Reduction of Experimental Myocardial Infarct Size by Corticosteroid Administration

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Why the study?

Does hydrocortisone administration reduce myocardial infarct size and ischemic injury in a canine model of acute coronary occlusion?

Structured PICO

Does hydrocortisone administration reduce myocardial infarct size and ischemic injury in a canine model of acute coronary occlusion?

Population

28 mongrel dogs of both sexes weighing 18 to 27 kg undergoing experimental acute coronary occlusion.

Intervention

Hydrocortisone hemisuccinate 50 mg/kg IV bolus administered either 30 minutes or 6 hours after coronary occlusion, with a supplementary dose of 25 mg/kg IV 12 hours after occlusion.

Comparator

Control group undergoing coronary occlusion without hydrocortisone treatment.

Outcome

Extent and severity of acute myocardial ischemic injury (average ST segment elevation and number of sites with ST > 2 mV) at 30 and 60 minutes, and myocardial necrosis (myocardial creatine phosphokinase activity [CPK] and histologic appearance) at 24 hours.surrogate

Pharmacological doses of hydrocortisone prevent myocardial cells from progressing to ischemic necrosis in a canine model, even when initiated up to 6 hours after coronary occlusion.

Limitations

Model is not suitable for study of the hemodynamic effects of such changes due to small hemodynamic alterations produced by mid-LAD occlusion in dogs.

Discussion

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Implication

Does not support clinical use in acute MI; hypothesis-generating for steroid effects on ischemic necrosis in larger models.

Cite This Study

Libby et al. (1973) studied this question.

synapsesocial.com/papers/6a1551a75347fbb1739f95da https://doi.org/10.1172/jci107221

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Reduction of Experimental Myocardial Infarct Size by Corticosteroid Administration

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Reduction of Experimental Myocardial Infarct Size by Corticosteroid Administration

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Also Consider