RESUMO
BACKGROUND: Monocyte chemoattractant protein-1 (MCP-1) plays an important role in the pathogenesis of acute coronary syndrome. We have recently demonstrated that the administration of edaravone before reperfusion attenuated reperfusion injury in patients with acute myocardial infarction (AMI). METHODS: Plasma MCP-1 levels were measured in 45 consecutive patients with AMI (edaravone group, n=25; control group, n=20). In the edaravone group, 30 mg edaravone was intravenously infused just before reperfusion. Plasma samples were obtained before and at 24h, 3, 5, 7, and 14 days after reperfusion. Cardiovascular events were defined as cardiac death, subacute thrombosis, or fatal arrhythmia. Heart failure requiring rehospitalization was evaluated at 12 months after reperfusion. RESULTS: Plasma MCP-1 levels were not different between the two groups before reperfusion. Compared with the placebo group, the edaravone group had statistically lower maximum creatine kinase-MB levels (218±31 IU/l versus 145±21 IU/l, p<0.05) and plasma MCP-1 levels on day 3 after reperfusion (873±118 pg/ml versus 516±66 pg/ml, p<0.05). Heart failure requiring rehospitalization occurred in four patients in the control group, but did not occur in the edaravone group (p<0.05). At 12 months after reperfusion, left ventricular ejection fraction was statistically higher in the edaravone group than in the control group (62±2% versus 54±3%, p<0.05). CONCLUSION: Edaravone suppressed plasma MCP-1, improved left ventricular ejection fraction, and reduced rehospitalization due to heart failure. Suppression of plasma MCP-1 level by edaravone might induce better prognosis for AMI patients.
