Long-term efficacy of edaravone in patients with acute myocardial infarction.

Background The effect of edaravone, a free radical scavenger, on long-term prognosis and its efficacy with regards to scavenging injurious free radicals in patients with acute myocardial infarction (AMI) was examined. Methods and Results One hundred and one initial AMI patients were randomly assigned to receive 30 mg edaravone (n=50) or a placebo (n=51) intravenously just before reperfusion. The infarct size, using serum biomarkers and Q-wave formations, and the incidence of reperfusion arrhythmia between the groups were compared. Cardiovascular event-free curves were estimated by using the Kaplan - Meier method. In addition, the serum thioredoxin levels, an oxidative stress marker, to assess the antioxidant effect of edaravone was determined. In all cases, successful reperfusion was obtained within 6 h after the onset of symptoms. Infarct size and reperfusion arrhythmia were significantly attenuated in the edaravone group compared with the placebo group (p=0.035 and p=0.031). The cumulative event-free rate was significantly higher in the edaravone group than in the placebo group (p=0.045). Serum thioredoxin levels were significantly lower in the edaravone group than in the placebo group throughout the acute phase. Conclusions The present study suggests that the edaravone administration just prior to reperfusion might reduce oxidative stress and improve the long-term clinical outcomes of AMI patients. (Circ J 2006; 70: 832 -837)