Cardiovascular Disorders

1. The cardioprotective effect of highly selective beta1 blockade using D140S during percutaneous coronary intervention

1.

Researcher(s):
W.J. Louis, M.Horrigan, B.Chan, C.J.O’Callaghan and G.P. Jackman, Department of Clinical Pharmacology & Therapeutics and Department of Cardiology, Austin & Repatriation Medical Centre.

Title:
The cardioprotective effect of highly selective beta1 blockade using D140S during percutaneous coronary intervention.

Aim:
To demonstrate whether use of D140S offers benefits in terms of heart rate and blood pressure control during the procedure and a reduction in myocardial damage after the procedure.

Summary:
Percutaneous coronary intervention (PCI) to reopen blocked coronary arteries involves inflation of a balloon catheter to widen the blocked areas and insertion of stents to keep the artery open. This procedure involves repeated balloon inflations, during which blood flow is completely stopped in the artery. This may lead to some cardiac damage as detected by raised cardiac enzymes in blood in about 20% of patients.

The trial is designed to show whether a short acting specific beta-blocker, D140S, can reduce this damage by controlling heart rate and reducing myocardial oxygen demand and lead to better long-term outcomes from the procedure. D140S has been selected because of its short duration of action, which allows us to control its effects with greater safety than conventional beta-blockers and secondly because of its high specificity for the cardiac beta1 receptor, which should avoid side effects associated with actions at beta2 receptors in lung and blood vessels seen with conventional beta-blockers.

As is true of the general population, the incidence of heart attack and arterial disease is increasing in the Veteran population and such treatment may greatly improve the safety and outcome of PCI treatment for Veterans.