Review Article

The Role of Mitochondrial Reactive Oxygen Species in Cardiovascular Injury and Protective Strategies

Table 3

Cardioprotective strategies targeting mitochondria in clinical trials.

TrialStrategyResults

NCT01502774 (CIRCUS trial)A bolus injection of CsA administered at the onset of myocardial reperfusion in patients with anterior ST-segment-elevation MI (STEMI) Worsened heart failure during the initial hospitalization, rehospitalization for heart failure, and adverse left ventricular remodeling at 1 year in 59.0% of the 395 patients randomized to cyclosporine and 58.1% of the 396 individuals randomized to placebo [148]

NCT01374321 (MITOCARE trial)I.v. bolus administration of TRO40303 (an inhibitor of mPTP opening) in STEMI patients undergoing primary PCI (percutaneous coronary intervention)TRO40303 did not show any protective effects as compared to placebo in preventing reperfusion injury in STEMI patients treated with primary PCI [149]

NCT01572909 (EMBRACE STEMI trial)MTP-131 (a cell-permeable peptide that preserves the integrity of cardiolipin, enhances mitochondrial energetics, and improves myocyte survival during reperfusion in animal models) administration for 1 h among first-time anterior STEMI subjects undergoing primary PCI for a proximal or mid left anterior descending (LAD) artery occlusionAdministration of MTP-131 was not associated with a significant reduction in infarct size or clinical outcomes [150]

NCT01584453 (NITRITE-AMI trial)Intracoronary injection of nitrite during primary PCI in STEI patientsThe phase II showed that intracoronary nitrite infusion did not change the infarct size. Yet, in a subgroup of patients with TIMI flow ≤1, nitrite reduced infarct size and MACE and improved myocardial salvage index indicating a follow-up with the phase III of the clinical trial [151]

NCT01388504 (NIAMI trial)Intravenous sodium nitrite administration immediately prior to PCI in patients with acute STEMI Myocardial infarct size did not differ between nitrite and placebo groups. There were no significant differences in plasma troponin I and CK area under the curve, left ventricular volumes, and ejection fraction measured at 6–8 days and at 6 months and final infarct size measured at 6 months [152]