title: No benefit of additional treatment with exenatide in patients with an acute myocardial infarction.
abstract: OBJECTIVE
  This double blinded, placebo controlled randomized clinical trial studies the effect of exenatide on myocardial infarct size. The glucagon-like peptide-1 receptor agonist exenatide has possible cardioprotective properties during reperfusion after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.
  
  
  METHODS
  191 patients were randomly assigned to intravenous exenatide or placebo initiated prior to percutaneous coronary intervention using 10μg/h for 30min followed by 0.84μg/h for 72h. Patients with a previous myocardial infarction, Trombolysis in Myocardial Infarction flow 2 or 3, multi-vessel disease, or diabetes were excluded. Magnetic resonance imaging (MRI) was performed to determine infarct size, area at risk (AAR) (using T2-weighted hyperintensity (T2W) and late enhancement endocardial surface area (ESA)). The primary endpoint was of 4-month final infarct size, corrected for the AAR measured in the acute phase using MRI.
  
  
  RESULTS
  After exclusion, 91 patients (age 57.4±10.1years, 76% male) completed the protocol. There were no baseline differences between groups. No difference was found in infarct size corrected for the AAR in the exenatide group compared to the placebo group (37.1±18.8 vs. 39.3±20.1%, p=0.662). There was also no difference in infarct size (18.8±13.2 vs. 18.8±11.3% of left ventricular mass, p=0.965). No major adverse cardiac events occurred during the in-hospital phase.
  
  
  CONCLUSIONS
  Exenatide did not reduce myocardial infarct size expressed as a percentage of AAR in ST elevated myocardial infarction patients successfully treated with percutaneous coronary intervention.
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands.
authors.forename: Sebastiaan T
authors.initials: ST
authors.lastname: Roos
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Leo
authors.initials: L
authors.lastname: Timmers
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Biesbroek
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Robin
authors.initials: R
authors.lastname: Nijveldt
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands.
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands.
authors.forename: Albert C
authors.initials: AC
authors.lastname: van Rossum
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gerardus P J
authors.initials: GP
authors.lastname: van Hout
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Pieter R
authors.initials: PR
authors.lastname: Stella
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Paul
authors.initials: P
authors.lastname: Knaapen
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Birgitta K
authors.initials: BK
authors.lastname: Velthuis
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Niels
authors.initials: N
authors.lastname: van Royen
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Michiel
authors.initials: M
authors.lastname: Voskuil
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Alex
authors.initials: A
authors.lastname: Nap
authors.affiliation: Department of Cardiology, Institute for Cardiovascular Research (ICaR-VU), VU University Medical Center, Amsterdam, The Netherlands; Interuniversity Cardiology Institute of the Netherlands (ICIN), Utrecht, The Netherlands. Electronic address: y.appelman@vumc.nl.
authors.forename: Yolande
authors.initials: Y
authors.lastname: Appelman
mesh_terms: D000368:Aged; D004311:Double-Blind Method; D000077270:Exenatide; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery*; D010455:Peptides / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000639:trends*; D011446:Prospective Studies; D016896:Treatment Outcome; D014688:Venoms / Q000008:administration & dosage*; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
chemical_list: D010455:Peptides; D014688:Venoms; D000077270:Exenatide; D000097789:Glucagon-Like Peptide-1 Receptor Agonists
keywords: Coronary artery disease; Exenatide; Infarct size; Myocardial infarction