l -精氨酸治疗急性心肌梗死:心肌梗死中血管与年龄的相互作用(VINTAGE MI)随机临床试验。

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引用

舒尔曼SP,贝克尔LC,卡斯DA, Champion HC,泰瑞ML,福尔曼S,恩斯特KV,克莱门MD,汤森SN,卡普里奥蒂A,海尔JM,格斯滕布利斯G

l -精氨酸治疗急性心肌梗死:心肌梗死中血管与年龄的相互作用(VINTAGE MI)随机临床试验。

《美国医学协会杂志》上。2006年1月4日;295(1):58-64。

PubMed ID
16391217 (PubMed视图
摘要

背景:氨基酸l -精氨酸是一氧化氮合酶的底物,并越来越多地用作健康补充剂。先前的研究表明,l -精氨酸有降低血管僵硬的潜力。目的:确定急性st段抬高型心肌梗死患者在梗死后标准治疗中加入l -精氨酸是否能在随访6个月后降低血管僵硬度并改善射血分数。设计和设置:2002年2月至2004年6月,采用单中心、随机、双盲、安慰剂对照试验。患者:共有153例首次st段抬高型心肌梗死患者入选;77例患者年龄≥60岁。干预:患者被随机分配接受l -精氨酸(目标剂量3克,每天3次)或匹配的安慰剂6个月。主要观察指标:60岁或60岁以上随机接受l-精氨酸的患者与接受安慰剂的患者相比,6个月内门控血池衍生射血分数的变化。次要结局包括所有入选患者射血分数的变化、无创血管硬度测量的变化和临床事件。结果:基线特征、血管硬度测量和左心室功能在随机接受安慰剂或l -精氨酸的参与者之间相似。 The mean (SD) age was 60 (13.6) years; of the participants, 104 (68%) were men. There was no significant change from baseline to 6 months in the vascular stiffness measurements or left ventricular ejection fraction in either of the 2 groups, including those 60 years or older and the entire study group. However, 6 participants (8.6%) in the L-arginine group died during the 6-month study period vs none in the placebo group (P = .01). Because of the safety concerns, the data and safety monitoring committee closed enrollment. CONCLUSIONS: L-arginine, when added to standard postinfarction therapies, does not improve vascular stiffness measurements or ejection fraction and may be associated with higher postinfarction mortality. L-arginine should not be recommended following acute myocardial infarction. Clinical Trial Registration ClinicalTrials.gov, NCT00051376.

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