Key result
Intravenous quercetin added to standard therapy significantly reduced infarct size, assessed by CK-MB AUC, compared to standard therapy alone (8036 vs 11219 U × 1 h/L, p=0.015) in STEMI patients.
Why the study?
Quercetin possesses antioxidant and anti-inflammatory properties, but its cardioprotective potential to limit infarct size in patients with STEMI required investigation.
Does intravenous quercetin reduce infarct size in patients with first anterior STEMI?
RCT (n=143)
Open-label
randomized
Yes
Does intravenous quercetin reduce infarct size in patients with first anterior STEMI?
Absolute Event Rate: 8036% vs 11219%
p-value: p=0.015
Intravenous quercetin added to standard therapy in patients with first anterior STEMI significantly reduces infarct size and reperfusion-induced intramyocardial hemorrhage.
Quercetin addition may limit infarct size in STEMI; leaves open confirmation of clinical benefit in larger trials.
OBJECTIVE: Myocardial infarction (MI) is one of the leading causes of death in the world. Early myocardial reperfusion improves acute MI survival. Bioflavonoid quercetin is known to have antioxidant, anti-inflammatory, and anti-proliferative properties. The presented pilot study aims to investigate the cardioprotective effect of quercetin on infarct size limiting in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Patients (n = 143) with first anterior STEMI within 6 hours from symptoms onset were included in this open-label multicenter pilot study. Patients were randomized either into quercetin group (n = 70) in addition to standard treatment or recommended therapy alone group (control group, n = 73). Quercetin infusions were initiated before reperfusion and repeated during the next 5 days. The infarct size assessed using creatine kinase-myocardial band area under curve (CK-MB AUC) was the primary study outcome. RESULTS: The study arms did not differ in demographics, time to admission, and main clinical data. The median early CK-MB AUC was significantly lower in quercetin group than in controls (8036 ± 7594 vs 11219 ± 8146 U × 1 h/L, p = 0.015). Intravenous quercetin administration was associated with less reperfusion-induced intramyocardial hemorrhage by Cardiac Magnetic Resonance on Day 3 (11.1% of patients in quercetin group vs 53.3% of patients in control group, p < 0.024). There were no significant differences in left ventricle ejection fraction and LV remodeling indicators. CONCLUSION: Our pilot study is the first to demonstrate novel insight into ischemia/reperfusion damage in STEMI patients. The addition of quercetin to standard STEMI therapy limits infarct size and prevents intramyocardial hemorrhage after the first anterior STEMI. Further research will be necessary to both validate and expand upon these findings.
No takes yet. Share an insight, caveat, or question.
Kozhukhov et al. (2023) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=143). Quercetin vs. Recommended therapy alone was evaluated on Infarct size assessed using creatine kinase-myocardial band area under curve (CK-MB AUC) (p=0.015). Intravenous quercetin added to standard therapy significantly reduced infarct size, assessed by CK-MB AUC, compared to standard therapy alone (8036 vs 11219 U × 1 h/L, p=0.015) in STEMI patients.
Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context: