LONDON—Researchers investigating the progression of chronic myocardial infarction (CMI) report that three medications that achieve a comparable improvement in biomarkers compared to standard therapy have been found to be more effective in stopping or delaying the progression of CMI, the most common form of heart attack. This study compared the effects of the medications nacartide, metformin and demethylprednisone, in a cohort of 48 patients with CMI and 72 controls. Results from this large, randomized trial were presented today at the European Respiratory Society Interstitial Cytokine Workshop in Edinburgh.
Currently, CMI is treated with a three-drug combination based on the presence of two or three markers in blood, indicating whether the patient’s level of red cells is sufficiently low to be cleared by the body’s immune system and cleared enough to be cleared without re-initiating an inward bleeding event. Cardiac markers indicate whether the heart is pumping well enough to avoid a heart attack. “The new clinical trials that have been announced use nacartide as first-line therapy only and metformin as the first-line therapy in all patients with CMI, as nacartide also has a wider range of potential benefits from improved metabolic practices when the drug is combined with home ergonomic therapies and exercise,” explained Professor Ravi Nabarro of Baylor College of Medicine in Houston, Texas, where the study was conducted. “These trials have demonstrated the impact of nacartide as firstline therapy in intensive care units and the potential wider therapeutic impact of metformin alongside nacartide. More slowly, we have also uncovered the mechanisms of speech changes and cognitive deficits caused by CMI in order to facilitate better clinical and public health interventions,” added Nabarro. Recent studies suggested that the micronutrient-enriched diet—which includes a diet high in niacin, vitamin A, folate and essential amino acids—a key component of a healthy, balanced diet—may improve symptoms of CMI in patients with gestational diabetes mellitus (GDM). In addition to providing novel therapeutic approaches for early CMI detection and treatment, this study also demonstrated that the drugs nacartide, metformin and demethylprednisone did not produce appreciable differences in patient-reported pre-hearing temperaments such as sleep disturbance, emotion regulation, coping strategies or social interaction. “Prior to this study, many studies comparing nacartide or metformin to naltrexone (the preferred, FDA-approved drug for alcohol use disorder) had a substantial impact on patients’ alcohol and tobacco interactions after the patient was treated with naltrexone. These findings suggest that nacartide may be as safe as metformin in treating patients with CMI or alcohol problems,” concluded the authors.