A multicenter double blind clinical trial on 3.4.5-trimethoxybenzoiyl-epsilon-aminocaproic acid (C-3) in acute
Insights
This study found that C-3 treatment significantly improved cardiac function and reduced mortality in acute myocardial infarction patients, especially in specific subgroups. C-3 demonstrated a positive impact on cardiac failure and overall survival rates.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Acute myocardial infarction (AMI) remains a leading cause of mortality worldwide.
- Effective treatments to improve patient outcomes and reduce complications are crucial.
Purpose of the Study:
- To evaluate the efficacy and safety of C-3 in patients with acute myocardial infarction.
- To assess the impact of C-3 on clinical progress, mortality, and specific complications.
Main Methods:
- A multicenter, double-blind, placebo-controlled clinical trial involving 391 patients with AMI.
- Patients received either C-3 (2g statim + 6g/24h for 5 days) or placebo intravenously.
- Clinical progress, mortality rates, and complication incidence were monitored.
Main Results:
- C-3 treatment showed a significant improvement in cardiac failure compared to placebo (P < 0.0025).
- Overall mortality was lower in the C-3 group (8.1% vs. 11.2%).
- Significant mortality reduction was observed in patients treated with C-3 for over 24 hours, male patients treated for over 12 hours, and patients under 60 years old.
Conclusions:
- C-3 demonstrates potential efficacy in managing acute myocardial infarction.
- The findings support the hypothesis that C-3 enhances traditional antiarrhythmic drugs and myocardial contractility.
- Further research into C-3's role in AMI management is warranted.
Abstract:
186 out of 391 patients with acute myocardial infarction were treated with C-3 and 205 with placebo in a multicenter, double-blind clinical trial. Ensuing complications were treated in the same way in both groups. C-3 was injected i.v. slowly at the dose of 2 g statim plus 6 g by continuous drip infusion over 24 hrs for 5 days. During treatment, clinical progress was influenced only in regard to cardiac failure since in the C-3 group the improvement was more significant than in the placebo one (P less than 0.0025). Mortality rates were 8.1% and 11.2% for the C-3 and placebo groups, respectively. The difference in mortality was significant (P less than 0.05) for patients treated with C-3 for more than 24 hours. Mortality in male patients treated with C-3 for more than 12 hours was significantly lower (P less than 0.025). In patients less than 60 years old mortality rate was significantly lower (P less than 0.05) and was more so in patients receiving C-3 for more than 12 hours (P less than 0.025). Mortality due to complications was lower in the C-3 group, with arrhythmias (9.8% vs 14.2%), cardiogenic shock (69.2% vs 75%), and cardiac failure (9% vs 19.4%). Results agree with the hypothesis that C-3 may be effective in acute myocardial infarction by improving the action of traditional antiarrhythmic drugs, and augmenting myocardial contraction energy.
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