Gianluca Campo1, Rita Pavasini2, Giampaolo Morciano3, A Michael Lincoff4, C Michael Gibson5, Masafumi Kitakaze6, Jacob Lonborg7, Amrita Ahluwalia8, Hideki Ishii9, Michael Frenneaux10, Michel Ovize11, Marcello Galvani12, Dan Atar13, Borja Ibanez14, Giampaolo Cerisano15, Simone Biscaglia2, Brandon J Neil5, Masanori Asakura6, Thomas Engstrom7, Daniel A Jones8, Dana Dawson16, Roberto Ferrari17, Paolo Pinton3, Filippo Ottani12. 1. Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy. Electronic address: cmpglc@unife.it. 2. Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy. 3. Department of Morphology, Surgery and Experimental Medicine, Section of Pathology, Oncology and Experimental Biology, University of Ferrara, Ferrara, Italy. 4. Cleveland Clinic Coordinating Center for Clinical Research (C5Research), Cleveland, OH, USA. 5. PERFUSE Study Group, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. 6. Cardiovascular Division of Medicine, National Cardiovascular Centre, Suita, Osaka, Japan. 7. Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. 8. Centre of Clinical Pharmacology, Barts NIHR Cardiovascular Biomedical Research Unit, William Harvey Research Institute, Barts & The London Medical School, Queen Mary University, London, UK. 9. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. 10. Norwich Medical School, University of East Anglia, Norwich, UK. 11. Clinical Investigation Center of Lyon, Lyon, France. 12. Unità Operativa di Cardiologia, Ospedale GB Morgagni, Forlì, Italy. 13. Department of Cardiology B, Oslo University Hospital Ullevall, and Faculty of Medicine, University of Oslo, Oslo, Norway. 14. Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC) and Instituto de Investigación-Fundación Jiménez Díaz Hospital, Madrid, Spain. 15. Division of Cardiology, University of Florence, Careggi Hospital, Florence, Italy. 16. School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK. 17. Cardiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Cona, FE, Italy; Maria Cecilia Hospital, GVM Care & Research, E.S.: Health Science Foundation, Cotignola, Italy.
Abstract
AIMS: To perform a systematic review and meta-analysis of randomized clinical trials (RCT) comparing the effectiveness of drugs targeting mitochondrial function vs. placebo in patients with ST-segment elevation myocardial infarction (STEMI) undergoing mechanical coronary reperfusion. METHODS: Inclusion criteria: RCTs enrolling STEMI patients treated with primary percutaneous coronary intervention (PCI) and comparing drugs targeting mitochondrial function vs. placebo. Odds ratios (OR) were computed from individual studies and pooled with random-effect meta-analysis. RESULTS: Fifteen studies were identified involving 5680 patients. When compared with placebo, drugs targeting mitochondrial component/pathway were not associated with significant reduction of cardiovascular and all-cause mortality (OR 0.9, 95% CI 0.7-1.17 and OR 0.92, 95% CI 0.69-1.23, respectively). However, these agents significantly reduced hospital admission for heart failure (HF) (OR 0.64; 95% CI 0.45-0.92) and increased left ventricular ejection fraction (LVEF) (OR 1.44; 95% CI 1.15-1.82). After analysis for subgroups according to the mechanism of action, drugs with direct/selective action did not reduce any outcome. Conversely, those with indirect/unspecific action showed a significant effect on cardiovascular mortality (0.65, 95% CI 0.46-0.92), all-cause mortality (OR 0.69, 95% CI 0.52-0.92), hospital readmission for HF (OR 0.41, 95% CI 0.28-0.6) and LVEF (OR 1.49, 95% CI 1.09-2.05). CONCLUSIONS: Administration of drugs targeting mitochondrial function in STEMI patients undergoing primary PCI appear to have no effect on mortality, but may reduce hospital readmission for HF. The drugs with a broad-spectrum mechanism of action seem to be more effective in reducing adverse events.
AIMS: To perform a systematic review and meta-analysis of randomized clinical trials (RCT) comparing the effectiveness of drugs targeting mitochondrial function vs. placebo in patients with ST-segment elevation myocardial infarction (STEMI) undergoing mechanical coronary reperfusion. METHODS: Inclusion criteria: RCTs enrolling STEMI patients treated with primary percutaneous coronary intervention (PCI) and comparing drugs targeting mitochondrial function vs. placebo. Odds ratios (OR) were computed from individual studies and pooled with random-effect meta-analysis. RESULTS: Fifteen studies were identified involving 5680 patients. When compared with placebo, drugs targeting mitochondrial component/pathway were not associated with significant reduction of cardiovascular and all-cause mortality (OR 0.9, 95% CI 0.7-1.17 and OR 0.92, 95% CI 0.69-1.23, respectively). However, these agents significantly reduced hospital admission for heart failure (HF) (OR 0.64; 95% CI 0.45-0.92) and increased left ventricular ejection fraction (LVEF) (OR 1.44; 95% CI 1.15-1.82). After analysis for subgroups according to the mechanism of action, drugs with direct/selective action did not reduce any outcome. Conversely, those with indirect/unspecific action showed a significant effect on cardiovascular mortality (0.65, 95% CI 0.46-0.92), all-cause mortality (OR 0.69, 95% CI 0.52-0.92), hospital readmission for HF (OR 0.41, 95% CI 0.28-0.6) and LVEF (OR 1.49, 95% CI 1.09-2.05). CONCLUSIONS: Administration of drugs targeting mitochondrial function in STEMI patients undergoing primary PCI appear to have no effect on mortality, but may reduce hospital readmission for HF. The drugs with a broad-spectrum mechanism of action seem to be more effective in reducing adverse events.
Authors: Gianluca Campo; Rita Pavasini; Giampaolo Morciano; Michael A Lincoff; Michael C Gibson; Masafumi Kitakaze; Jacob Lonborg; Amrita Ahluwalia; Hideki Ishii; Michael Frenneaux; Michel Ovize; Marcello Galvani; Dan Atar; Borja Ibanez; Giampaolo Cerisano; Simone Biscaglia; Brandon J Neil; Masanori Asakura; Thomas Engstrom; Daniel A Jones; Dana Dawson; Roberto Ferrari; Paolo Pinton; Filippo Ottani Journal: Data Brief Date: 2017-07-18