SIN-1 has no direct myocardial anti-ischemic action

Area of Science:

• Cardiology
• Pharmacology

Background:

• Anti-ischemic drugs exert effects through peripheral or cardiac mechanisms.
• Molsidomine's active metabolite, SIN-1, is known for its anti-ischemic activity.

Purpose of the Study:

• To investigate if SIN-1 has a direct myocardial anti-ischemic effect.
• To differentiate between direct cardiac and indirect vascular actions of SIN-1.

Main Methods:

• A double-blind, randomized study involving three groups of seven patients.
• Administration of 0.4 mg SIN-1 via intracoronary (IC) or intravenous (IV) routes, or placebo.
• Monitoring of surface and intracoronary electrocardiogram (ECG), hemodynamics, and angina severity.

Main Results:

• SIN-1 did not alter ischemic ECG parameters.
• No significant changes in peripheral or central hemodynamics were observed.
• Low-dose IC or IV SIN-1 did not reduce angina severity.

Conclusions:

• SIN-1 does not demonstrate a direct myocardial anti-ischemic effect.
• The anti-ischemic activity of SIN-1 and molsidomine is attributed to peripheral and cardiac vascular responses.