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Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design
Novel therapies capable of reducing myocardial infarct (MI) size when administered prior to reperfusion are required to prevent the onset of heart failure in ST‐segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). Experimental animal...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wiley Periodicals, Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489325/ https://www.ncbi.nlm.nih.gov/pubmed/25990305 http://dx.doi.org/10.1002/clc.22401 |
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author | Bulluck, Heerajnarain Fröhlich, Georg M. Mohdnazri, Shah Gamma, Reto A. Davies, John R. Clesham, Gerald J. Sayer, Jeremy W. Aggarwal, Rajesh K. Tang, Kare H. Kelly, Paul A. Jagathesan, Rohan Kabir, Alamgir Robinson, Nicholas M. Sirker, Alex Mathur, Anthony Blackman, Daniel J. Ariti, Cono Krishnamurthy, Arvindra White, Steven K. Meier, Pascal Moon, James C. Greenwood, John P. Hausenloy, Derek J. |
author_facet | Bulluck, Heerajnarain Fröhlich, Georg M. Mohdnazri, Shah Gamma, Reto A. Davies, John R. Clesham, Gerald J. Sayer, Jeremy W. Aggarwal, Rajesh K. Tang, Kare H. Kelly, Paul A. Jagathesan, Rohan Kabir, Alamgir Robinson, Nicholas M. Sirker, Alex Mathur, Anthony Blackman, Daniel J. Ariti, Cono Krishnamurthy, Arvindra White, Steven K. Meier, Pascal Moon, James C. Greenwood, John P. Hausenloy, Derek J. |
author_sort | Bulluck, Heerajnarain |
collection | PubMed |
description | Novel therapies capable of reducing myocardial infarct (MI) size when administered prior to reperfusion are required to prevent the onset of heart failure in ST‐segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). Experimental animal studies have demonstrated that mineralocorticoid receptor antagonist (MRA) therapy administered prior to reperfusion can reduce MI size, and MRA therapy prevents adverse left ventricular (LV) remodeling in post‐MI patients with LV impairment. With these 2 benefits in mind, we hypothesize that initiating MRA therapy prior to PPCI, followed by 3 months of oral MRA therapy, will reduce MI size and prevent adverse LV remodeling in STEMI patients. The MINIMISE‐STEMI trial is a prospective, randomized, double‐blind, placebo‐controlled trial that will recruit 150 STEMI patients from four centers in the United Kingdom. Patients will be randomized to receive either an intravenous bolus of MRA therapy (potassium canrenoate 200 mg) or matching placebo prior to PPCI, followed by oral spironolactone 50 mg once daily or matching placebo for 3 months. A cardiac magnetic resonance imaging scan will be performed within 1 week of PPCI and repeated at 3 months to assess MI size and LV remodeling. Enzymatic MI size will be estimated by the 48‐hour area‐under‐the‐curve serum cardiac enzymes. The primary endpoint of the study will be MI size on the 3‐month cardiac magnetic resonance imaging scan. The MINIMISE STEMI trial will investigate whether early MRA therapy, initiated prior to reperfusion, can reduce MI size and prevent adverse post‐MI LV remodeling. |
format | Online Article Text |
id | pubmed-4489325 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wiley Periodicals, Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-44893252015-07-07 Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design Bulluck, Heerajnarain Fröhlich, Georg M. Mohdnazri, Shah Gamma, Reto A. Davies, John R. Clesham, Gerald J. Sayer, Jeremy W. Aggarwal, Rajesh K. Tang, Kare H. Kelly, Paul A. Jagathesan, Rohan Kabir, Alamgir Robinson, Nicholas M. Sirker, Alex Mathur, Anthony Blackman, Daniel J. Ariti, Cono Krishnamurthy, Arvindra White, Steven K. Meier, Pascal Moon, James C. Greenwood, John P. Hausenloy, Derek J. Clin Cardiol Trial Designs Novel therapies capable of reducing myocardial infarct (MI) size when administered prior to reperfusion are required to prevent the onset of heart failure in ST‐segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). Experimental animal studies have demonstrated that mineralocorticoid receptor antagonist (MRA) therapy administered prior to reperfusion can reduce MI size, and MRA therapy prevents adverse left ventricular (LV) remodeling in post‐MI patients with LV impairment. With these 2 benefits in mind, we hypothesize that initiating MRA therapy prior to PPCI, followed by 3 months of oral MRA therapy, will reduce MI size and prevent adverse LV remodeling in STEMI patients. The MINIMISE‐STEMI trial is a prospective, randomized, double‐blind, placebo‐controlled trial that will recruit 150 STEMI patients from four centers in the United Kingdom. Patients will be randomized to receive either an intravenous bolus of MRA therapy (potassium canrenoate 200 mg) or matching placebo prior to PPCI, followed by oral spironolactone 50 mg once daily or matching placebo for 3 months. A cardiac magnetic resonance imaging scan will be performed within 1 week of PPCI and repeated at 3 months to assess MI size and LV remodeling. Enzymatic MI size will be estimated by the 48‐hour area‐under‐the‐curve serum cardiac enzymes. The primary endpoint of the study will be MI size on the 3‐month cardiac magnetic resonance imaging scan. The MINIMISE STEMI trial will investigate whether early MRA therapy, initiated prior to reperfusion, can reduce MI size and prevent adverse post‐MI LV remodeling. Wiley Periodicals, Inc. 2015-05-19 /pmc/articles/PMC4489325/ /pubmed/25990305 http://dx.doi.org/10.1002/clc.22401 Text en © 2015 The Authors. Clinical Cardiology published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Trial Designs Bulluck, Heerajnarain Fröhlich, Georg M. Mohdnazri, Shah Gamma, Reto A. Davies, John R. Clesham, Gerald J. Sayer, Jeremy W. Aggarwal, Rajesh K. Tang, Kare H. Kelly, Paul A. Jagathesan, Rohan Kabir, Alamgir Robinson, Nicholas M. Sirker, Alex Mathur, Anthony Blackman, Daniel J. Ariti, Cono Krishnamurthy, Arvindra White, Steven K. Meier, Pascal Moon, James C. Greenwood, John P. Hausenloy, Derek J. Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title | Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title_full | Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title_fullStr | Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title_full_unstemmed | Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title_short | Mineralocorticoid Receptor Antagonist Pretreatment to MINIMISE Reperfusion Injury After ST‐Elevation Myocardial Infarction (The MINIMISE STEMI Trial): Rationale and Study Design |
title_sort | mineralocorticoid receptor antagonist pretreatment to minimise reperfusion injury after st‐elevation myocardial infarction (the minimise stemi trial): rationale and study design |
topic | Trial Designs |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4489325/ https://www.ncbi.nlm.nih.gov/pubmed/25990305 http://dx.doi.org/10.1002/clc.22401 |
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