title: Impact of cyclosporine A use in the prevention of reperfusion injury in acute myocardial infarction: A meta-analysis.
abstract: BACKGROUND
  Reperfusion injury is an important limiting factor associated with revascularization in acute myocardial infarction (AMI). Various therapies have been tried in an attempt to prevent reperfusion injury, but the search has been elusive. The role of cyclosporine A (CsA) in the prevention of reperfusion injury in AMI is still not clear. The objective of this study was to find out whether CsA is beneficial in reducing reperfusion injury in acute ST elevation myocardial infarction.
  
  
  METHODS
  We performed a systematic search of Pubmed, Scopus, clinicaltrial.gov, and Cochrane Database for randomized control trials (RCT) measuring the effect of CsA in AMI compared to a placebo. The Mantel-Haenszel method and random effect model were used to analyze the data. A total of 1,566 patients (776 in the CsA group and 790 in the placebo group), who participated in 5 RCTs were included in our meta-analysis.
  
  
  RESULTS
  We did not find any significant differences between the CsA and placebo groups in terms of all-cause death (odds ratio [OR] 1.21, 95% confidence interval [CI] 0.78-1.87) and cardiovascular death (OR 1.05, 95% CI 0.66-2.49). Similarly, we did not find any significant differences in terms of cardiogenic shock, recurrent ischemia and myocardial infarction, heart failure and echocardiographic outcomes.
  
  
  CONCLUSIONS
  Cyclosporine A is not helpful in preventing reperfusion injury in AMI.
authors.affiliation: Department of Internal Medicine, Hurley Medical Center/Michigan State University, One Hurley Plaza, Flint, MI, United States. supadha1@hurleymc.com.
authors.forename: Sunil
authors.initials: S
authors.lastname: Upadhaya
authors.forename: Seetharamprasad
authors.initials: S
authors.lastname: Madala
authors.forename: Ramkaji
authors.initials: R
authors.lastname: Baniya
authors.forename: Suresh Kumar
authors.initials: SK
authors.lastname: Subedi
authors.forename: Kalyan
authors.initials: K
authors.lastname: Saginala
authors.forename: Ghassan
authors.initials: G
authors.lastname: Bachuwa
mesh_terms: D016572:Cyclosporine / Q000627:therapeutic use*; D004452:Echocardiography; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D009203:Myocardial Infarction / Q000150:complications / Q000188:drug therapy*; D015428:Myocardial Reperfusion Injury / Q000209:etiology / Q000517:prevention & control*
chemical_list: D007166:Immunosuppressive Agents; D016572:Cyclosporine
keywords: cyclosporine A; mitochondrial permeability transition pore protein; myocardial infarction; reperfusion injury