Trial opens new possibilities for improving survival with a novel heart attack drug

CHICAGO -- While the results of a new trial showed that a novel drug intended to reduce the extent of cell death after heart attack did not do so, the surprising finding that it reduced the death rate in patients who received angioplasties opens an intriguing new line of investigation, according to Duke University Medical Center researchers.

The drug, known as pexelizumab, was tested in a Phase II trial in conjunction with either clot-busting medications or angioplasty in acute heart attack patients to reduce the amount of tissue death, or infarct size, following treatment. The researchers, led by Duke cardiologists Christopher Granger, M.D., and Kenneth Mahaffey, M.D., found that while the infarct size remained the same in the treated and untreated groups, there was a greater than three times reduction (1.8 percent vs. 5.9 percent) in the death rate after 90 days in the patients who received the drug in conjunction with angioplasty.

"Unexpected findings like these can in many ways be the most exciting, because they open up whole new avenues of investigation," Granger said. He presented the results of the trial (Nov. 18, 2002) at the 75th annual scientific session of the American Heart Association.

"Although pexelizumab did not reduce the size of infarcts, the results may be pointing toward a novel mechanism that seems to benefit some patients with acute heart attacks," Granger continued. "This is quite exciting and worthy of further study."

In many ways, heart attack patients suffer twice. First, when blood flow is cut off to heart muscle during the attack, the resulting lack of oxygen kills or damages heart muscle cells. Then, after blood flow is restored, either by medication or angioplasty, the starved muscle cells are damaged again as a result of the sudden return of oxygen-rich blood, a condition known as reperfusion injury.

To date, no effective therapy has been discovered to reduce or stop the damage of reperfusion in

Contact: Richard Merritt
Duke University Medical Center

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