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April 1, 2012Circulation Cardiovascular Interventions

Effect of Iron Chelation on Myocardial Infarct Size and Oxidative Stress in ST-Elevation–Myocardial Infarction

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Key result

Deferoxamine administered before primary percutaneous coronary intervention for STEMI did not significantly reduce CMRI-determined infarct size compared with placebo (17.4% vs 18.6%; P=0.73).

Why the study?

Does deferoxamine administered before primary PCI reduce myocardial infarct size and oxidative stress in patients with ST-elevation-MI?

Population

60 patients with ST-elevation-myocardial infarction undergoing primary percutaneous coronary intervention

Comparison

Deferoxamine intravenous bolus immediately… vs Normal saline bolus and infusion (placebo)

Design

RCT, randomly assigned

Follow-up

3 months (100±17 days)

Authors

WCWilliam ChanATAndrew J. TaylorAEA. Ellims

Discussion

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Overview

Does not support deferoxamine before primary PCI to limit STEMI infarct size; challenges iron chelation for acute cardioprotection.

Study Design

Type

RCT (n=60)

Structured PICO

Does deferoxamine administered before primary PCI reduce myocardial infarct size and oxidative stress in patients with ST-elevation-MI?

P
Population
60 patients with ST-elevation-myocardial infarction undergoing primary percutaneous coronary intervention, followed for 3 months.
I
Intervention
Deferoxamine (DFO) intravenous bolus (500 mg) immediately before PPCI followed by a 12-hour infusion (50 mg/kg of body weight)
C
Comparator
Normal saline bolus and infusion (placebo)
O
Outcome
Myocardial infarct (MI) size measured by contrast-enhanced cardiac MRI (CMRI) at day 3±1surrogate

Main Result

Absolute Event Rate: 17.4% vs 18.6%

p-value: p=0.73

Adjunctive intravenous deferoxamine administered before primary PCI in STEMI patients reduces oxidative stress but does not reduce myocardial infarct size.

Cite This Study

Chan et al. (2012) conducted an RCT in ST-elevation-myocardial infarction (n=60). Deferoxamine vs. Placebo (normal saline) was evaluated on CMRI-determined infarct size at day 3±1 (p=0.73). Deferoxamine administered before primary percutaneous coronary intervention for STEMI did not significantly reduce CMRI-determined infarct size compared with placebo (17.4% vs 18.6%; P=0.73).

synapsesocial.com/papers/6a86f354d00295e3b4bef892https://doi.org/10.1161/circinterventions.111.966226
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Does reperfusion injury exist in humans?1993 · 397 citations
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