Effect of pentoxifylline on endothelial dysfunction, oxidative stress and inflammatory markers in STEMI patients
Asmaa Saeed1, Mohamed Moustafa Farouk2, Nagwa Ali Sabri1
1Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, 11566, Egypt.
Insights
Pentoxifylline (PTX) treatment for ST-elevation myocardial infarction (STEMI) patients was found to be safe and well-tolerated. However, it did not significantly improve markers of endothelial dysfunction, oxidative stress, or inflammation over two months.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- ST-elevation myocardial infarction (STEMI) is associated with increased mortality and adverse outcomes.
- Endothelial dysfunction (ED) is a key factor contributing to these adverse outcomes in STEMI patients.
- Identifying effective treatments to mitigate ED and its consequences is crucial.
Purpose of the Study:
- To evaluate the efficacy of pentoxifylline (PTX) in improving endothelial dysfunction and related markers in STEMI patients.
- To assess the safety and tolerability of PTX in this patient population.
Main Methods:
- A randomized controlled trial involving 43 STEMI patients.
- Patients were assigned to receive either PTX (400 mg thrice daily) or a placebo for two months.
- Biomarkers including soluble vascular cell adhesion molecule-1, malondialdehyde, IL-1, IL-6, hs-CRP, and TNF-α were measured at baseline and after treatment.
Main Results:
- No significant differences in the measured markers were observed between the PTX and placebo groups after two months.
- A statistically significant reduction in high-sensitivity C-reactive protein (hs-CRP) was noted within the PTX group.
- Pentoxifylline was demonstrated to be safe and well-tolerated by STEMI patients.
Conclusions:
- Two months of pentoxifylline treatment in STEMI patients is safe and well-tolerated.
- PTX did not demonstrate a significant effect on endothelial dysfunction, oxidative stress, or key inflammatory markers in this study.
- Further research may be needed to explore potential therapeutic roles or optimal dosing of PTX in cardiovascular conditions.
Abstract:
Aim: ST-elevation myocardial infarction (STEMI) patients suffer higher mortality and adverse outcomes linked to endothelial dysfunction (ED). Methods: 43 patients were randomized to pentoxifylline (PTX) 400 mg thrice daily (n = 22) or placebo (n = 21). Soluble vascular cell adhesion molecule-1, malondialdehyde, interleukin-1 (IL-1), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and tumor necrosis factor-α (TNF-α) were assessed at baseline and 2 months. Results: After 2 months, no significant difference was observed in markers' levels between the 2 groups. However, a within-group comparison revealed a statistically significant change in hs-CRP in the PTX group (10.057 (9.779-10.331) versus 9.721 (6.102-10.191)), p = 0.032. Conclusion: PTX for 2 months in STEMI patients was safe and well-tolerated but had no significant detectable effect on ED, oxidative stress or inflammatory markers. Clinical Trial Registration: NCT04367935 (ClinicalTrials.gov).
