Effects of Glucagon Like Peptide-1 on No-reflow

Not Applicable

• Conditions: Acute ST-segment Elevation Myocardial Infarction
• Interventions: Drug: placebo; Drug: liraglutide

• Registration Number: NCT02507128
• Lead Sponsor: Chen Wei Ren, MD

Brief Summary

The investigators planned to evaluate the effects of liraglutide on no-reflow in patients with acute ST-segment elevation myocardial infarction (STEMI).

Detailed Description

Acute myocardial infarction (AMI) is a major cause of mortality and morbidity. Primary percutaneous coronary intervention (PCI) is currently the most effective treatment strategy for AMI. Brisk thrombolysis in myocardial infarction (TIMI) grade 3 flow immediately after PCI in patients with AMI is associated with improved clinical outcomes compared with lower flow grades. However, myocardial reperfusion is suboptimal in many patients, mostly because of the 'no-reflow' phenomenon. No-reflow is defined as suboptimal myocardial reperfusion in part of the coronary circulation without angiographic evidence of mechanical vessel obstruction. To date, however, very few drugs have been shown to reverse established no-reflow.

Glucagon-like peptide-1 (GLP-1) is an incretin hormone that regulates plasma glucose, and GLP-1 analogues were recently introduced for the treatment of acute myocardial infarction. GLP-1 has antioxidant and anti-inflammatory properties, and may protect endothelial function. Experimental studies have also revealed that GLP-1 or its analogues protect against reperfusion injury in pigs. Exenatide, a GLP-1 analogue, was reported to reduce reperfusion injury in patients with ST-segment elevation myocardial infarction. Similarly, liraglutide was reported to reduce cardiac rupture and infarct size and improve cardiac output in normal and diabetic mice. To date, however, there is no clinical evidence for the effects of liraglutide on no-reflow in patients with AMI. Therefore, the aim of this study was to evaluate the effects of liraglutide pretreatment on myocardial no-reflow of prime PCI in patients with AMI.

Study Timeline

• Status Verified: 2015-07
• Study Start: 2015-07
• Study First Submitted: 2015-07-22
• Study First Submitted QC: 2015-07-22
• Last Update Submitted: 2015-07-22
• Study First Posted: 2015-07-23
• Last Update Posted: 2015-07-23
• Primary Completion: 2016-07
• Study Completion: 2016-07

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 190

Inclusion Criteria

Patients with ST-segment elevation myocardial infarction were eligible for the study.

Exclusion Criteria

Patients were excluded for the following reasons: unconscious at presentation; had cardiogenic shock, hypoglycaemia, or diabetic ketoacidosis; had a history of myocardial infarction, stent thrombosis, or renal insufficiency; or had previously undergone coronary artery bypass surgery.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Control group	placebo	the treatment started 30 min before PCI with a dose of 1.8 mg placebo (the treatment was administered in the ambulance).
GLP-1 group	liraglutide	The treatment started 30 min before PCI with a dose of 1.8 mg liraglutide (the treatment was administered in the ambulance).

Primary Outcome Measures

Name	Time	Method
a change in the prevalence of no-reflow	immediately after PCI	The primary efficacy variable was the prevalence of no-reflow assessed immediately post procedure.

Secondary Outcome Measures

Name	Time	Method
a change in troponin T	immediately after PCI, at 1,3,5 days after PCI	Secondary efficacy variable was troponin T level.
a change in high-sensitivity C-reactive protein (hsCRP)	immediately after PCI, at 1,3,5 days after PCI	Secondary efficacy variable was high-sensitivity C-reactive protein level.
a change in superoxide dismutase (SOD)	immediately after PCI, at 1,3,5 days after PCI	Secondary efficacy variable was superoxide dismutase level.

Trial Locations

Locations (1)

PLA General Hospital; 🇨🇳 Beijing, Beijing, China