Key result
Methylprednisolone increased cardiac index (P<0.02) and oxygen consumption index (146 to 170 ml/min/m2; P<0.05) after acute myocardial infarction, with no specific effects on P50, 2,3 DPG or Ca-VO2.
Why the study?
Does methylprednisolone infusion alter P50, 2,3 DPG, arteriovenous oxygen difference, or cardiac index in patients with acute myocardial infarction?
RCT (n=28)
Double-blind
randomized
Does methylprednisolone infusion alter P50, 2,3 DPG, arteriovenous oxygen difference, or cardiac index in patients with acute myocardial infarction?
p-value: p=<0.02
High-dose methylprednisolone increases cardiac index and oxygen consumption in acute myocardial infarction but does not affect hemoglobin oxygen affinity or arteriovenous oxygen difference.
In a double-blind randomized study, 30 mg/kg of methylprednisolone sodium succinate (MPN) or 15 mg/kg of mannitol placebo (PL) were infused in 28 patients after acute myocardial infarction. Measurements were obtained immediately before and after for 24 hours after the initial infusion. The partial pressure of oxygen at 50% saturation of hemoglobin (P50) did not change significantly in vitro or in vivo after MPN, whereas 2,3 diphosphoglycerate (2,3 DPG) increased from 13.2 to 14.2 mumol/g Hb (p < 0.05) in the group receiving PL. The arteriovenous oxygen difference (Ca-VO2) remained constant after MPN or PL. The cardiac index (CI) increased after MPN (p < 0.02) associated with an increase in the oxygen consumption index (CI X A-V O2) from 146 to 170 ml/min/m2 (p < 0.05). These data show that MPN increases CI after acute myocardial infarction, but has no specific effects on P50, 2,3 DPG or Ca-VO2.
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Kalter et al. (1980) conducted an RCT in acute myocardial infarction (n=28). methylprednisolone sodium succinate vs. mannitol placebo (15 mg/kg) was evaluated on cardiac index (CI) and oxygen consumption index (p=<0.02). Methylprednisolone increased cardiac index (P<0.02) and oxygen consumption index (146 to 170 ml/min/m2; P<0.05) after acute myocardial infarction, with no specific effects on P50, 2,3 DPG or Ca-VO2.
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