Myocardial Protection of Exenatide in AMI

Cardioprotective Effects of Exenatide in Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention ; Results of Exenatide Myocardial Protection In REvascularization (EMPIRE) Study

Experimental evidence suggests exenatide, a glucagon-like peptide 1 receptor analogue, has significant cardiovascular protective effects in various conditions. The investigators examined whether conventional use of exenatide at the time of primary percutaneous coronary intervention would reduce the infarct size in patients with ST-segment elevation myocardial infarction (STEMI).

In this proof-of-concept trial, we assessed the effects of acute-phase adjunctive exenatide therapy in patients with STEMI.

Infarct size after STEMI was evaluated by both cardiac magnetic resonance image and cardiac biomarkers compared with standard treatment.

LV function was assessed by conventional and speckle tracking echocardiography. During 6-month follow up, the safety/tolerability of exenatide and clinical outcomes were also assessed.

Inclusion Criteria:

• age between 20 and 79 years
• patients presenting with first ST-segment elevation myocardial infarction
• Thrombolysis in Myocardial Infarction [TIMI] flow grade 0)

Exclusion Criteria:

• cardiac arrest
• ventricular fibrillation
• cardiogenic shock
• hemodynamic instability
• suspicious stent thrombosis
• left bundle branch block
• previous acute myocardial infarction
• previous coronary artery bypass operation
• significant valvular heart disease
• primary myocardial disease
• atrial fibrillation
• significant hepatic or renal dysfunction, hypoglycaemia,
• diabetic ketoacidosis
• active infection or chronic inflammatory disease
• malignancy
• women who were pregnant or who were of childbearing age