Saturday, October 12, 2013

Short Term Doxycycline Therapy may help in Remodeling of Heart after PCI

Short term doxycycline therapy may be helpful in the remodelling of heart after per-cutaneous coronary intervention.
This was based on the fact that chlamydia are found on the atherosclerosis plaques. In some study, researchers have tried with Roxythromycin in patients of Coronary Artery Disease, the result was not encouraging.

Intracoronary thrombus removed from a coronary...
Intracoronary thrombus removed from a coronary artery during a percutaneous coronary intervention to abort a myocardial infarction. Five pieces of thrombus are shown (arrow heads). Wikipedia)

In an experimental study published in the Oxford Journals , it has been found that doxycycline attenuates post-infarction remodeling and exerts protective effects on myocardial ischemia/reperfusion injury.
They studied the effect of doxycycline in phase II trial, on left ventricular (LV) remodeling in patients with acute ST-segment elevation myocardial infarction (STEMI) and LV dysfunction in 110 patients.
Immediately after primary percutaneous coronary intervention, patients with STEMI and LV ejection fraction <40% were randomly assigned to doxycycline (100 mg b.i.d. for 7 days) in addition to standard therapy, or to standard care.
The echo LV end-diastolic volumes index (LVEDVi) was determined at baseline and 6 months. 99mTc-Sestamibi-single-photon emission computed tomography infarct size and severity were assessed at 6 months.
The 6-month changes in % of LVEDVi were significant smaller in the doxycycline group than in the control group as well as infarct size and infarct severity respectively.
In patients with acute STEMI and LV dysfunction, doxycycline reduces the adverse LV remodelling for comparable definite myocardial infarct size.
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