Poloxamer-188 as an adjunct to primary percutaneous transluminal coronary angioplasty for acute myocardial infarction

James H. O'Keefe, Cindy L. Grines, Marcus A. DeWood, Gary L. Schaer, Kevin Browne, Raymond D. Magorien, John M. Kalbfleisch, William O. Fletcher, Timothy M. Bateman, Raymond J. Gibbons

Research output: Contribution to journalArticle

31 Scopus citations

Abstract

Poloxamer-188 is a surfactant polymer with antithrombotic and hemorheologic properties that make it potentially useful as an adjunct to acute reperfusion strategies. Animal studies and early human studies have documented poloxamer-188 to be effective at improving myocardial salvage when used as an adjunct to intravenous thrombolytic therapy for acute myocardial infarction. The current trial was a prospective pilot study involving 150 patients who were randomized in a 2:1 fashion to a poloxamer-188 infusion for 48-hours versus placebo. The poloxamer-188 infusion was well tolerated subjectively. The only clinically significant laboratory abnormality noted was an elevation in the serum creatinine above 2.0 g/dl in 12% (n = 12) of the 98 poloxamer-188 treated patients versus 1 of the 52 (2%) of the placebo treated patients (p = 0.048). Clinical end points including reinfarction (1% vs 4%), cardiogenic shock (7% vs 6%), and death (9% vs 4%) were statistically similar in the poloxamer-188 and placebo groups, respectively (p = NS). Using quantitative nuclear techniques, final infarct size and myocardial salvage were statistically similar in the poloxamer-188 and placebo groups. Mean left ventricular ejection fractions 1 week post after infarction were 51% ±12% in the poloxamer-188 group and 52% ±13% in the placebo group (p = NS). Final infarct size, was not altered by the poloxamer-188 infusion; however, it was significantly correlated with normal perfusion (Thrombolysis in Myocardial Infarction grade 3 flow) in the infarct vessel after angioplasty. This study documented poloxamer-188 to be ineffective as an adjunct to primary angioplasty for acute myocardial infarction and resulted in azotemia in 12% of the patients.

Original languageEnglish (US)
Pages (from-to)747-750
Number of pages4
JournalAmerican Journal of Cardiology
Volume78
Issue number7
DOIs
StatePublished - Jan 1 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    O'Keefe, J. H., Grines, C. L., DeWood, M. A., Schaer, G. L., Browne, K., Magorien, R. D., Kalbfleisch, J. M., Fletcher, W. O., Bateman, T. M., & Gibbons, R. J. (1996). Poloxamer-188 as an adjunct to primary percutaneous transluminal coronary angioplasty for acute myocardial infarction. American Journal of Cardiology, 78(7), 747-750. https://doi.org/10.1016/S0002-9149(96)00414-6