Effect of Cyclosporine a on Infarct Size Reduction in Reperfused Acute Myocardial Infarction Treated with Primary Angioplasty

Introduction: Cyclosporine A (CsA) administered as i.v. bolus before primary angioplasty (PPCI) was reported to significantly reduce infarct size (IS) in 58 STEMI pts. Hypothesis: CsA may reduce IS in a larger, randomized, multicenter study. Methods: All patients presenting at one of the 31 participating CCUs with a large STEMI within 6 hours of symptom onset (ST↑ in ≥ 3 leads in anterior MI or ST↑and/or↓ in ≥ 4 leads in non-anterior MI location) with a TIMI-flow 0/1 in the culprit artery, and committed to PPCI, were randomly assigned to CsA (2.5 mg/Kg i.v.) or no-CsA, before PPCI. The primary end-point was a >=70% ST resolution 60 min after TIMI-flow 3. Secondary end-points included centrally assayed high-sensitive Troponin T (hs-cTnT) on day 4, LV remodeling and function, and clinical events at 6-month follow-up. In-hospital results are presented, before completion of 6-mo follow-up. Results:410 STEMI pts (207 CsA/203 control) had a mean age of 63 ± 12 (SD) yrs. Twenty percent of pts were women, and 14....