TY - JOUR AU - Siddiqi, N AU - Neil, C AU - Bruce, M AU - MacLennan, G AU - Cotton, S AU - Papadopoulou, S AU - Feelisch, M AU - Bunce, N AU - Lim, PO AU - Hildick-Smith, D AU - Horowitz, J AU - Madhani, M AU - Boon, N AU - Dawson, D AU - Kaski, JC AU - Frenneaux, M Y2 - 2021/02/04 Y1 - 2014/05/01 SN - 0195-668X UR - http://hdl.handle.net/11343/259024 AB - AIM: Despite prompt revascularization of acute myocardial infarction (AMI), substantial myocardial injury may occur, in part a consequence of ischaemia reperfusion injury (IRI). There has been considerable interest in therapies that may reduce IRI. In experimental models of AMI, sodium nitrite substantially reduces IRI. In this double-blind randomized placebo controlled parallel-group trial, we investigated the effects of sodium nitrite administered immediately prior to reperfusion in patients with acute ST-elevation myocardial infarction (STEMI). METHODS AND RESULTS: A total of 229 patients presenting with acute STEMI were randomized to receive either an i.v. infusion of 70 μmol sodium nitrite (n = 118) or matching placebo (n = 111) over 5 min immediately before primary percutaneous intervention (PPCI). Patients underwent cardiac magnetic resonance imaging (CMR) at 6-8 days and at 6 months and serial blood sampling was performed over 72 h for the measurement of plasma creatine kinase (CK) and Troponin I. Myocardial infarct size (extent of late gadolinium enhancement at 6-8 days by CMR-the primary endpoint) did not differ between nitrite and placebo groups after adjustment for area at risk, diabetes status, and centre (effect size -0.7% 95% CI: -2.2%, +0.7%; P = 0.34). There were no significant differences in any of the secondary endpoints, including plasma troponin I and CK area under the curve, left ventricular volumes (LV), and ejection fraction (EF) measured at 6-8 days and at 6 months and final infarct size (FIS) measured at 6 months. CONCLUSIONS: Sodium nitrite administered intravenously immediately prior to reperfusion in patients with acute STEMI does not reduce infarct size. LA - English PB - OXFORD UNIV PRESS T1 - Intravenous sodiumnitrite in acute ST-elevation myocardial infarction: a randomized controlled trial (NIAMI) DO - 10.1093/eurheartj/ehu096 IS - European Heart Journal VL - 35 IS - 19 SP - 1255-+ L1 - /bitstream/handle/11343/259024/PMC4019912.pdf?sequence=1&isAllowed=y ER -