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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Protective effects of anisodamine on renal function in patients with ST-segment elevation myocardial infarction
Yanbo Wang1, Xianghua Fu, Xuechao Wang
1Department of Cardiology, the Second Hospital of Hebei Medical University, Shijiazhuang, PR China.
Insights
Anisodamine may protect kidney function in heart attack patients undergoing primary percutaneous coronary intervention (PCI). This study found lower rates of contrast-induced nephropathy (CIN) in patients receiving anisodamine compared to placebo.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- ST-segment elevation myocardial infarction (STEMI) requires primary percutaneous coronary intervention (PCI).
- STEMI patients undergoing PCI face increased risk of contrast-induced nephropathy (CIN).
- Anisodamine, a herbal alkaloid, shows potential renal protective properties.
Purpose of the Study:
- To evaluate the efficacy of anisodamine in preventing CIN in STEMI patients undergoing primary PCI.
- To assess the impact of anisodamine on renal function markers post-PCI.
Main Methods:
- A randomized controlled trial involving 126 STEMI patients undergoing primary PCI.
- Patients received either anisodamine or a placebo.
- Serum creatinine (SCr) and estimated glomerular filtration rate (eGFR) were monitored at baseline and 24, 48, 72 hours post-PCI.
Main Results:
- The incidence of CIN was significantly lower in the anisodamine group (5.0% at 24h, 8.3% at 48h, 6.7% at 72h) compared to the control group (16.7% at 24h, 22.7% at 48h, 19.7% at 72h).
- Renal function recovery patterns were observed in both groups post-PCI.
- Anisodamine administration was not associated with serious adverse effects.
Conclusions:
- Intravenous anisodamine administration before and after primary PCI may reduce the incidence of CIN in STEMI patients.
- Anisodamine demonstrates a protective effect on renal function in this high-risk patient population.
- Further research may support anisodamine as an adjunct therapy to mitigate CIN risk.
Abstract:
ST-segment elevation myocardial infarction (STEMI) is the most severe type of heart attack, and primary percutaneous coronary intervention (PCI) is the first line treatment for STEMI. However, these patients are at higher risk of contrast-induced nephropathy (CIN), which increases the length of hospital stay and mortality rate. Anisodamine, an alkaloid extracted from a Chinese herb, has been shown to exert protective effects on the renal function. The aim of this study was to investigate the protective effect of anisodamine on CIN in STEMI patients undergoing primary PCI. A total of 126 consecutive STEMI patients were randomly assigned to receive anisodamine (n=60) or placebo (control, n=66) from admission to 24 hours after PCI. The serum creatinine (SCr) concentrations, estimated glomerular filtration rate (eGFR) and incidence of CIN were measured on admission, and 24, 48 and 72 hours after PCI between the two groups. We found that the renal function of all patients after PCI underwent a course from injury to recovery. The incidence of CIN was 5.0%, 8.3%, and 6.7% at 24, 48 and 72 hours, respectively, after primary PCI in anisodamine group, while in control group it was 16.7%, 22.7%, and 19.7%, respectively. The incidence of CIN in anisodamine group was lower than that in control group during 72 hours after PCI (all P<0.05). In conclusion, intravenous infusion of anisodamine before and after primary PCI may reduce the occurrence of CIN in STEMI patients undergoing primary PCI, without serious side effects.
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