急性心筋梗塞におけるコルキシンによる抗炎症治療:パイロット研究

Spyridon Deftereos¹, Georgios Giannopoulos², Christos Angelidis¹

¹From Department of Cardiology, Athens General Hospital "G. Gennimatas", Greece (S.D., G.G., C.A., N.P., V.P.); 2nd Department of Cardiology, University of Athens Medical School, Attikon University Hospital, Greece (S.D., G.G., G.F., J.L.); Cardiology Department, Athens Euroclinic, Greece (N.A.); AHEPA University Hospital, Thessaloniki, Greece (G.S.); 1st Department of Cardiology, University of Ioannina Medical School, Greece (J.G.); Cardiology Department, University of Patras, Greece (D.A.); Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT (M.W.C.); and 1st Department of Cardiology, University of Athens Medical School, Hippokration Hospital, Greece (A.S.M., D.T.).

Circulation

|August 13, 2015

まとめ

コルキシン治療は,STセグメント上昇性心筋梗塞 (STEMI) の患者で心筋梗塞の大きさを有意に減少させた. この抗炎症薬は,再注射傷害による心臓損傷を制限する有望な効果を示しています.

科学分野:

心臓病科
薬理学について
炎症に関する研究

背景:

STセグメント上昇性心筋梗塞 (STEMI) のイシェミア/再注射性損傷は,炎症プロセスによって有意に媒介される.
コルヒシンは抗炎症剤で心血管疾患の患者には安全です
この研究では,STEMIにおける心臓発作の大きさを減らすコルキシンの可能性を調査した.

研究の目的:

STEMI患者の心臓発作の大きさを短期間コルキシンが減少させるという仮説を検証する.
主要な皮膚経冠動脈介入の補助療法としてのコルキシンの有効性を評価する.

主な方法:

151 STEMI患者 (痛み発症から≤12時間) は,コルキシンまたはプラセボを5日間投与された.
主要結果: クレアチンキナーゼと心筋の脳分数の曲線の下の面積
二次的結果: ガドリニウム増強による心臓MRIによる心臓発作の大きさ

主要な成果:

コルキシンは,クレアチンキナーゼと心筋の脳分数の曲線下の領域を有意に減少させた (P< 0. 001).
MRIによってインデックスされた心臓発作の大きさは,コルキシン群で小さかった (18. 3 mL/ 1. 73 m2 vs 23. 2 mL/ 1. 73 m2; P=0. 019).
コルキシン投与では,相対的な心臓発作の大きさが有意に減少した (13. 0% vs 19. 8%; P=0. 034).

結論:

コルキシンは,STEMIにおける心臓発作の大きさの減少に潜在的利点を示しています.
これらの発見を確認し,臨床結果を評価するために,さらなる臨床試験が必要である.
この研究は臨床的エンドポイントを評価する能力がなかったため,より大きな研究が必要であった.

キーワード:

MBフォーム曲線下の面積クレアチンキナーゼガドリニウム磁気共鳴画像検査中性子トロポニンT

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