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Randomized Controlled Trial
. 2019 Jul;23(7):4592-4600.
doi: 10.1111/jcmm.14306. Epub 2019 May 8.

Sodium tanshinone IIA sulfonate prevents the adverse left ventricular remodelling: Focus on polymorphonuclear neutrophil-derived granule components

Shuai Mao  1   2 , Shalina Taylor  2 , Qubo Chen  3 , Minzhou Zhang  1 , Aleksander Hinek  4
Affiliations
Randomized Controlled Trial

Sodium tanshinone IIA sulfonate prevents the adverse left ventricular remodelling: Focus on polymorphonuclear neutrophil-derived granule components

Shuai Mao et al. J Cell Mol Med. 2019 Jul.

Abstract

Aims: The aims of this study were to evaluate the effects of sodium tanshinone IIA sulfonate (STS) on left ventricular (LV) remodelling after for ST-elevated myocardial infarction (STEMI).

Methods and results: In this prospective, randomized clinical trial, 101 patients with the ST-elevated MI (STEMI) and a successful reperfusion were immediately randomized to receive STS (80 mg qd for 7 days) or saline control, along with standard therapy. The primary effectiveness endpoint is the % change in LV end diastolic volumes index (%∆ LVEDVi) as measured by echocardiography from baseline to 6 months. Secondary effectiveness endpoints include 6-month period for major adverse cardiac events (MACE), including the occurrence of recurrent myocardial infarction, death, hospitalization for heart failure and malignant arrhythmia. The 6-month changes in %∆ LVEDVi were significantly smaller in the STS group than in the control group [-5.05% vs 3.32%; P < 0.001]. With respect to MACE, there was a significant difference between those who received STS (8.16%) and those patients on control (26.00%) (P = 0.019). Meaningfully, results of parallel tests aimed at mechanistic explanation of the reported clinical effects, revealed a significantly reduced levels of neutrophils-derived granule components in the blood of STS treated patients.

Conclusion: We found that short-term treatment with STS reduced progressive left ventricular remodelling and subsequent better clinical outcome that could be mechanistically linked to the inhibition of the ultimate damage of infarcted myocardium by infiltrating neutrophils.

Keywords: left ventricular remodelling; myocardial infarction; neutrophils-derived granule components; sodium tanshinone IIA sulfonate.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study flow diagram. STS, sodium tanshinone IIA sulfonate
Figure 2
Figure 2
Echocardiographic changes from baseline to 6 months in LVEDVi, LVESVi and LVEF in the STS and control groups. Middle hash of the box indicates the median; 25‐75th percentiles are represented by end caps of the box; the whiskers indicate the 10th and 90th percentiles. LVEDVi, left ventricular end‐diastolic volumes index; LVESVi, left ventricular end‐systolic volume index; and LVEF, left ventricular ejection fraction
Figure 3
Figure 3
Proteomics and biosystematics analysis. A, Cluster analysis of the differentially expressed cytokines in the plasma compared between the STS patients and the control patients. B, Significant functional annotations of differentially expressed cytokines using GO analysis according to biological process ranked by enrichment score. C, KEGG pathways analysis of the differentially expressed proteins
Figure 4
Figure 4
Quantification of neutrophils‐derived granule components. Levels of neutrophils‐derived granule components, including neutrophil elastase, myeloperoxidase, proteinase 3, NGAL, MMP‐8 and MMP‐9 in patients receiving STS or saline control were assessed by ELISA. NGAL, neutrophil gelatinase‐associated lipocalin. MMP, matrix metalloproteinases
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References

    1. Bhatt AS, Ambrosy AP, Velazquez EJ. Adverse remodeling and reverse remodeling after myocardial infarction. Curr Cardiol Rep. 2017;19(8):71. - PubMed
    1. Carbone F, Nencioni A, Mach F, Vuilleumier N, Montecucco F. Pathophysiological role of neutrophils in acute myocardial infarction. Thromb Haemost. 2013;110(3):501‐514. - PubMed
    1. Goldmann BU, Rudolph V, Rudolph TK, et al. Neutrophil activation precedes myocardial injury in patients with acute myocardial infarction. Free Radic Biol Med. 2009;47(1):79‐83. - PubMed
    1. Akpek M, Kaya MG, Lam YY, et al. Relation of neutrophil/lymphocyte ratio to coronary flow to in‐hospital major adverse cardiac events in patients with ST‐elevated myocardial infarction undergoing primary coronary intervention. Am J Cardiol. 2012;110(5):621‐627. - PubMed
    1. Meissner J, Irfan A, Twerenbold R, et al. Use of neutrophil count in early diagnosis and risk stratification of AMI. Am J Med. 2011;124(6):534‐542. - PubMed

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