RECOMBINANT HUMAN SUPEROXIDE-DISMUTASE (H-SOD) FAILS TO IMPROVE RECOVERY OF VENTRICULAR-FUNCTION IN PATIENTS UNDERGOING CORONARY ANGIOPLASTY FAR ACUTE MYOCARDIAL-INFARCTION

Background Animal studies have demonstrated a burst of oxygen free rad ical generation after reperfusion of ischemic myocardium that could be blocked by administration of the free radical scavenger recombinant h uman superoxide dismutase (h-SOD). A multicenter, randomized, placebo- controlled clinical trial was designed to test the hypothesis that fre e radical-mediated reperfusion injury could be reduced by intravenous administration of h-SOD begun before percutaneous transluminal coronar y angioplasty (PTCA) in patients with acute transmural myocardial infa rction. Methods and Results One hundred twenty patients were randomize d to receive placebo (n=59) or h-SOD (n=61) given as a 10-mg/kg intrav enous bolus followed by a 60-minute infusion of 0.2 mg . kg(-1) . min( -1). Left ventricular function was analyzed via paired contrast left v entriculograms performed before PTCA and after 6 to 10 days and paired radionuclide ventriculograms performed within 24 hours of PTCA and af ter 4 to 6 weeks. Both h-SOD- and placebo-treated patients showed impr ovement in global and regional left ventricular function after success ful reperfusion. Compared with the placebo group, no additional improv ement was observed in the patients treated with hSOD. Conclusions The results of this clinical trial failed to demonstrate a beneficial effe ct of h-SOD on global or regional left ventricular function in patient s who underwent successful PTCA for treatment of acute myocardial infa rction.