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oai:repisalud.isciii.es:20.500.12105/133122024-11-29T09:50:08Zcom_20.500.12105_19604com_20.500.12105_2051com_20.500.12105_15322col_20.500.12105_19605col_20.500.12105_16977col_20.500.12105_16987col_20.500.12105_16986
Repisalud author Garcia Del Blanco, Bruno author Otaegui, Imanol author Rodríguez-Palomares, Jose author Bayes-Genis, Antoni author Fernandez-Nofrerias, Eduard author Vilalta Del Olmo, Victoria author Carrillo, Xavier author Ibáñez, Borja author Worner, Fernando author Casanova, Juan author Pueo, Eva author Gonzalez-Juanatey, Jose R author Lopez-Pais, Javier author Bardaji, Alfredo author Bonet, Gil author Fuertes, Monica author Rodriguez-Sinovas, Antonio author Ruiz-Meana, Marisol author Inserte, Javier author Barba, Ignasi author Gomez-Talavera, Sandra author Marti, Gerard author Serra, Bernat author Bellera, Neus author Ojeda-Ramos, Manuel author Cuellar, Hug author Valente, Filipa author Carmona, Maria Angeles author Miro-Casas, Elisabet author Marsal, Josep R author Sambola, Antonia author Lidon, Rosa M author Bañeras, Jordi author Elizaga, Jaime author Padilla, Ferran author Barrabés, José A author Hausenloy, Derek J author Ferreira-Gonzalez, Ignacio author Garcia-Dorado, David funder Instituto de Salud Carlos III funder Government of Catalonia (España) 2021-08-26T06:25:20Z 2021-08-26T06:25:20Z 2021-01 Basic Res Cardiol. 2021; 116(1):4 10.1007/s00395-021-00842-2 1435-1803 Basic research in cardiology 33495853 http://hdl.handle.net/20.500.12105/13312 Remote ischemic conditioning (RIC) and the GLP-1 analog exenatide activate different cardioprotective pathways and may have additive effects on infarct size (IS). Here, we aimed to assess the efficacy of RIC as compared with sham procedure, and of exenatide, as compared with placebo, and the interaction between both, to reduce IS in humans. We designed a two-by-two factorial, randomized controlled, blinded, multicenter, clinical trial. Patients with ST-segment elevation myocardial infarction receiving primary percutaneous coronary intervention (PPCI) within 6 h of symptoms were randomized to RIC or sham procedure and exenatide or matching placebo. The primary outcome was IS measured by late gadolinium enhancement in cardiac magnetic resonance performed 3-7 days after PPCI. The secondary outcomes were myocardial salvage index, transmurality index, left ventricular ejection fraction and relative microvascular obstruction volume. A total of 378 patients were randomly allocated, and after applying exclusion criteria, 222 patients were available for analysis. There were no significant interactions between the two randomization factors on the primary or secondary outcomes. IS was similar between groups for the RIC (24 ± 11.8% in the RIC group vs 23.7 ± 10.9% in the sham group, P = 0.827) and the exenatide hypotheses (25.1 ± 11.5% in the exenatide group vs 22.5 ± 10.9% in the placebo group, P = 0.092). There were no effects with either RIC or exenatide on the secondary outcomes. Unexpected adverse events or side effects of RIC and exenatide were not observed. In conclusion, neither RIC nor exenatide, or its combination, were able to reduce IS in STEMI patients when administered as an adjunct to PPCI. eng Effect of COMBinAtion therapy with remote ischemic conditioning and exenatide on the Myocardial Infarct size: a two-by-two factorial randomized trial (COMBAT-MI). journal article URL https://repisalud.isciii.es/bitstreams/fcfedac9-f96e-4cde-952f-d2201f0a9fff/download File MD5 2bc11d09672721c96be1b35fc87f23fd 1030642 application/pdf EffectofCOMBinAtionTherapy_2021.pdf URL https://repisalud.isciii.es/bitstreams/162aa9f2-080e-40ad-98d8-d6514d91f9ef/download File MD5 1f6fd4fe4fb4539709f1e98cacffd445 62857 text/plain EffectofCOMBinAtionTherapy_2021.pdf.txt