Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Cardiovascular Drugs and Therapy
Erschienen in: Cardiovascular Drugs and Therapy 6/2015

01.12.2015 | ORIGINAL ARTICLE

Rationale and Design of Sodium Tanshinone IIA Sulfonate in Left Ventricular Remodeling Secondary to Acute Myocardial Infarction (STAMP-REMODELING) Trial: A Randomized Controlled Study

verfasst von: Shuai Mao, Xiaotong Li, Lei Wang, Phillip C. Yang, Minzhou Zhang

Erschienen in: Cardiovascular Drugs and Therapy | Ausgabe 6/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

Left ventricular (LV) remodeling in ischemic cardiomyopathy is the leading cause of heart failure and is an established prognostic factor for adverse cardiovascular events. Experimental studies suggest that sodium tanshinone IIA sulfonate attenuates cardiac remodeling in animal models of acute myocardial infarction (AMI). However, the effects of this drug in the clinical setting remain unclear. Therefore, the STAMP-REMODELING trial is set up to investigate whether treatment with sodium tanshinone IIA sulfonate would prevent the maladaptive progression to adverse LV remodeling in patients following ST-segment elevation myocardial infarction (STEMI).

Methods

Approximately 80 patients with STEMI successfully treated with primary percutaneous coronary intervention (PCI) will be enrolled and randomized to receive sodium tanshinone IIA sulfonate (80 mg q.d. for 7 days) in addition to standard therapy or the same volume of hydration per day. The primary endpoint is the variation in LV end-diastolic volume index (LVEDVi) assessed with cardiac magnetic resonance imaging (CMR) at baseline and 6 months.

Conclusion

This study will provide important clinical evidence on the efficacy of sodium tanshinone IIA sulfonate treatment in patients with STEMI when used in combination with current therapies that may significantly reduce adverse LV remodeling and potentially improve clinical outcomes.
Trial Registration: Clinical Trials.gov: NCT02524964.
Literatur
1.
Sutton MG, Sharpe N. Left ventricular remodeling after myocardial infarction: pathophysiology and therapy. Circulation. 2000;101:2981–8.CrossRefPubMed
2.
Gaudron P, Eilles C, Kugler I, et al. Progressive left ventricular dysfunction and remodeling after myocardial infarction. Potential mechanisms and early predictors. Circulation. 1993;87:755–63.CrossRefPubMed
3.
González A, Ravassa S, Beaumont J, et al. New targets to treat the structural remodeling of the myocardium. J Am Coll Cardiol. 2011;58:1833–43.CrossRefPubMed
4.
Weir RA, Murphy CA, Petrie CJ, et al. Microvascular obstruction remains a portent of adverse remodeling in optimally treated patients with left ventricular systolic dysfunction after acute myocardial infarction. Circ Cardiovasc Imaging. 2010;3:360–7.CrossRefPubMed
5.
Ishii H, Amano T, Matsubara T, et al. Pharmacological intervention for prevention of left ventricular remodeling and improving prognosis in myocardial infarction. Circulation. 2008;118:2710–8.CrossRefPubMed
6.
Abdulla J, Barlera S, Latini R, et al. A systematic review: effect of angiotensin converting enzyme inhibition on left ventricular volumes and ejection fraction in patients with a myocardial infarction and in patients with left ventricular dysfunction. Eur J Heart Fail. 2007;9:129–35.CrossRefPubMed
7.
Bellenger NG, Rajappan K, Rahman SL, et al. Effects of carvedilol on left ventricular remodelling in chronic stable heart failure: a cardiovascular magnetic resonance study. Heart. 2004;90:760–4.PubMedCentralCrossRefPubMed
8.
JeevananthamV BM, Saad A, et al. Adult bone marrow cell therapy improves survival and induces long-term improvement in cardiac parameters: a systematic review and meta-analysis. Circulation. 2012;126:551–68.CrossRef
9.
Bolognese L, Neskovic AN, Parodi G, et al. Left ventricular remodeling after primary coronary angioplasty: patterns of left ventricular dilation and long-term prognostic implications. Circulation. 2002;106:2351–7.CrossRefPubMed
10.
Springeling T, Kirschbaum SW, Rossi A, et al. Late cardiac remodeling after primary percutaneous coronary intervention-five-year cardiac magnetic resonance imaging follow-up. Circ J. 2012;77:81–8.CrossRefPubMed
11.
Xu W, Yang J, Wu LM. Cardioprotective effects of tanshinone IIA on myocardial ischemia injury in rats. Pharmazie. 2009;64:332–6.PubMed
12.
Yang F, Li P, Li H, et al. microRNA-29b mediates the antifibrotic effect of tanshinone IIA in postinfarct cardiac remodeling. J Cardiovasc Pharmacol. 2015;65:456–64.CrossRefPubMed
13.
Wang P, Wu X, Bao Y, et al. Tanshinone IIA prevents cardiac remodeling through attenuating NAD(P)H oxidase-derived reactive oxygen species production in hypertensive rats. Pharmazie. 2011;66:517–24.PubMed
14.
Qiu X, Miles A, Jiang X, et al. Sulfotanshinone sodium injection for unstable angina pectoris: a systematic review of randomized controlled trials. Evid Based Complement Alternat Med. 2012;2012:715790.PubMedCentralPubMed
15.
Zhang H, Long M, Wu Z, et al. Sodium tanshinone IIA silate as an add-on therapy in patients with unstable angina pectoris. J Thorac Dis. 2014;6:1794–9.PubMedCentralPubMed
16.
Mao S, Wang L, Zhao X, et al. Sodium tanshinone IIA sulfonate for reduction of periprocedural myocardial injury during percutaneous coronary intervention (STAMP trial): rationale and design. Int J Cardiol. 2015;182:329–33.CrossRefPubMed
17.
Seo WS, Lee JH, Sun X, et al. FeCo/graphitic-shell nanocrystals as advanced magnetic-resonance-imaging and near-infrared agents. Nat Mater. 2006;5:971–6.CrossRefPubMed
18.
Hendel RC, Patel MR, Kramer CM, et al. ACCF/ ACR/SCCT/SCMR/ASNC /NASCI/SCAI/SIR 2006 appropriateness criteria for cardiac computed tomography and cardiac magnetic resonance imaging. J Am Coll Cardiol. 2006;48:1475–97.CrossRefPubMed
19.
Soliman OI, Kirschbaum SW, van Dalen BM, et al. Accuracy and reproducibility of quantitation of left ventricular function by real-time three-dimensional echocardiography versus cardiac magnetic resonance. Am J Cardiol. 2008;102:778–83.CrossRefPubMed
20.
Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126:2020–35.CrossRefPubMed
21.
Windecker S, Kolh P, Alfonso F, et al. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35:2541–619.CrossRefPubMed
22.
Baccouche H, Mahrholdt H, Meinhardt G, et al. Diagnostic synergy of non-invasive cardiovascular magnetic resonance and invasive endomyocardial biopsy in troponin-positive patients without coronary artery disease. Eur Heart J. 2009;30:2869–79.CrossRefPubMed
23.
Suzuki Y, Yeung AC, Yang PC. Cardiovascular MRI for stem cell therapy. Curr Cardiol Rep. 2007;9:45–50.CrossRefPubMed
24.
Yan AT, Shayne AJ, Brown KA, et al. Characterization of the peri-infarct zone by contrast-enhanced cardiac magnetic resonance imaging is a powerful predictor of post-myocardial infarction mortality. Circulation. 2006;114:32–9.CrossRefPubMed
25.
Orn S, Manhenke C, Greve OJ, et al. Microvascular obstruction is amajor determinant of infarct healing and subsequent left ventricular remod-elling following primary percutaneous coronary intervention. Eur Heart J. 2009;30:1978–85.CrossRefPubMed
26.
Iraqi W, Rossignol P, Angioi M, et al. Extracellular cardiac matrix biomarkers in patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure: insights from the Eplerenone Post-Acute Myocardial Infarction Heart Failure Efficacy and Survival Study (EPHESUS) study. Circulation. 2009;119:2471–9.CrossRefPubMed
27.
Fertin M, Hennache B, Hamon M, et al. Usefulness of serial assessment of B-type natriuretic peptide, troponin I, and C-reactive protein to predict left ventricular remodeling after acute myocardial infarction (from the REVE-2 study). Am J Cardiol. 2010;106:1410–6.CrossRefPubMed
28.
Kramer DG, Trikalinos TA, Kent DM, et al. Quantitative evaluation of drug or device effects on ventricular remodeling as predictors of therapeutic effects on mortality in patients with heart failure and reduced ejection fraction: a meta-analytic approach. J Am Coll Cardiol. 2010;56:392–406.PubMedCentralCrossRefPubMed
29.
Cerisano G, Buonamici P, Valenti R, et al. Early short-termdoxycycline therapy in patients with acute myocardial infarction and left ventricular dysfunction to prevent the ominous progression to adverse remodelling: the TIPTOP trial. Eur Heart J. 2014;35:184–91.CrossRefPubMed
30.
Mao S, Wang Y, Zhang M, et al. Phytoestrogen, tanshinone IIA diminishes collagen deposition and stimulates elastogenesis in cultures of human cardiac fibroblasts. Exp Cell Res. 2014;10:62–7.
31.
Fang ZY, Lin R, Yuan BX, et al. Tanshinone IIA inhibits atherosclerotic plaque formation by down-regulating MMP-2 and MMP-9 expression in rabbits fed a high-fat diet. Life Sci. 2007;81:1339–45.CrossRefPubMed
32.
Webb CS, Bonnema DD, Ahmed SH, et al. Specific temporal profile of matrix metalloproteinase release occurs in patients after myocardial infarction: relation to left ventricular remodeling. Circulation. 2006;114:1020–7.CrossRefPubMed
33.
Zhang Y, Wei L, Sun D, et al. Tanshinone IIA pretreatment protects myocardium against ischaemia/reperfusion injury through the phosphatidylinositol 3-kinase/Akt-dependent pathway in diabetic rats. Diabetes Obes Metab. 2010;12:316–22.CrossRefPubMed
34.
Wu TW, Zeng LH, Fung KP, et al. Effect of sodium tanshinone IIA sulfonate in the rabbit myocardium and on human cardiomyocytes and vascular endothelial cells. Biochem Pharmacol. 1993;46:2327–32.CrossRefPubMed
35.
Jenkins C, Moir S, Chan J, et al. Left ventricular volume measurement with echocardiography: a comparison of left ventricular opacification, three-dimensional echocardiography, or both with magnetic resonance imaging. Eur Heart J. 2009;30:98–106.CrossRefPubMed
36.
Robbers LF, Eerenberg ES, Teunissen PF, et al. Magnetic resonance imaging-defined areas of microvascular obstruction after acute myocardial infarction represent microvascular destruction and haemorrhage. Eur Heart J. 2013;34:2346–53.CrossRefPubMed
Metadaten
Titel
Rationale and Design of Sodium Tanshinone IIA Sulfonate in Left Ventricular Remodeling Secondary to Acute Myocardial Infarction (STAMP-REMODELING) Trial: A Randomized Controlled Study
verfasst von
Shuai Mao
Xiaotong Li
Lei Wang
Phillip C. Yang
Minzhou Zhang
Publikationsdatum
01.12.2015
Verlag
Springer US
Erschienen in
Cardiovascular Drugs and Therapy / Ausgabe 6/2015
Print ISSN: 0920-3206
Elektronische ISSN: 1573-7241
DOI
https://doi.org/10.1007/s10557-015-6625-2

Weitere Artikel der Ausgabe 6/2015

Cardiovascular Drugs and Therapy 6/2015 Zur Ausgabe

SHORT COMMUNICATION

Exogenous SDF-1α Protects Human Myocardium from Hypoxia-Reoxygenation Injury via CXCR4

ORIGINAL ARTICLE

Impact of Intracoronary Adenosine on Myonecrosis in Patients with Unstable Angina Pectoris Undergoing Percutaneous Coronary Intervention

REVIEW ARTICLE

From Protecting the Heart to Improving Athletic Performance – the Benefits of Local and Remote Ischaemic Preconditioning

ORIGINAL ARTICLE

Altered microRNome Profiling in Statin-Induced HepG2 Cells: A Pilot Study Identifying Potential new Biomarkers Involved in Lipid-Lowering Treatment

ORIGINAL ARTICLE

The Impact of Peripheral Nerve Stimulation on Coronary Blood Flow and Endothelial Function

REVIEW ARTICLE

Adenylyl Cyclase 9 Polymorphisms Reveal Potential Link to HDL Function and Cardiovascular Events in Multiple Pathologies: Potential Implications in Sickle Cell Disease

Neu im Fachgebiet Kardiologie

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Dihydropyridin-Kalziumantagonisten können auf die Nieren gehen

30.04.2024 Hypertonie Nachrichten

Im Vergleich zu anderen Blutdrucksenkern sind Kalziumantagonisten vom Diyhdropyridin-Typ mit einem erhöhten Risiko für eine Mikroalbuminurie und in Abwesenheit eines RAS-Blockers auch für ein terminales Nierenversagen verbunden.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen
Bildnachweise