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Can polyprezinc have additional benefits for patients with acute myocardial infarction?

Can polyprezinc have additional benefits for patients with acute myocardial infarction?

  • Categories:Stomach healthy
  • Author:
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  • Time of issue:2020-11-18
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(Summary description)

Can polyprezinc have additional benefits for patients with acute myocardial infarction?

(Summary description)

  • Categories:Stomach healthy
  • Author:
  • Origin:
  • Time of issue:2020-11-18
  • Views:0
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  Can polyprezinc have additional benefits for patients with acute myocardial infarction?

  Acute myocardial infarction (AMI) refers to the acute occlusion of the coronary arteries and interruption of blood flow, which causes ischemic necrosis of the local myocardium. Clinical manifestations include persistent retrosternal pain, shock, arrhythmia, and heart failure, as well as increased serum myocardial enzymes and changes in electrocardiogram. Cardiovascular disease, especially acute myocardial infarction (AMI), is an important cause of death. Studies have shown that pro-inflammatory cytokines (IL-6) and C-reactive protein (CRP) in the blood of AMI patients are up-regulated, and the involvement of inflammation is considered to be the onset of acute coronary syndrome (including arteriosclerosis-related lesions and AMI) Important mechanism.

  Zinc is an indispensable trace element in the human body. It participates in the synthesis of more than 300 enzymes in the human body. At the same time, it also has the effect of stabilizing cell membranes and anti-oxidation. Polyprezinc is a chelate composed of zinc ions and L-carnosine, which is used clinically to treat gastric ulcers; studies have found that Polyprezinc can induce the mobilization of mesenchymal stem cells and insulin-like growth factors in vascular endothelial cells (IGF)1 mRNA expression in order to protect the damaged gastric tissue or gastric mucosa; at the same time, studies have confirmed that zinc has an effect on myocardial ischemia and reperfusion, then whether polyprezinc affects the cardiac function of AMI patients What about the impact?

  We did the following research:

  Percutaneous Coronary Intervention

  This prospective, open, randomized clinical study was approved by the ethics committee on November 16, 2011, and all patients provided written informed consent.

  1. Research objects: 50 patients with initial ST-segment elevation myocardial infarction (2011.9-2014.7) successfully underwent percutaneous coronary intervention (PCI) within 12 hours after the onset of AMI.

  2. Randomly divide into control group: C group (non-polyprezinc, n=26) and P group (polyprezinc, n=24).

  Patients in the 3.P group took 75 mg polyprezinc each time, twice a day, for 9 months.

  4. On the 8th day after taking Polyprezinc, collect peripheral blood and urine samples within a specified period of time to analyze the zinc concentration, myocardial enzymes and the levels of inflammation markers (CRP and IL-6). In order to evaluate the ejection fraction (EF), left ventricular end diastolic diameter (LVDd) and left ventricular end systolic diameter (LVDs) in terms of cardiac function, echocardiography was performed on admission and 9 months after surgery.    5. All patients received 100 mg aspirin and 75 mg clopidogrel as dual antiplatelet therapy and 4 mg candesartan after PCI. 8 days after PCI, all patients were treated with statins.

  Research result

  1. Compared with group C, the zinc concentration of group P increased significantly after 8 days of polyprezinc administration (96.5[85.75–110.5] and 80[65.25–97.75]μg/dL; P=0.020, respectively) (Figure 1A) ; At the same time, the urine zinc level in group P was also higher, but there was no significant difference (843[623–1780] and 763[510–1030]μg/L; P=.176) (Figure 1B), indicating that Polyprezinc increases the concentration of zinc in the patient's body.    Figure 1 The concentration of zinc in blood and urine

  2. Myocardial enzyme (CPK) is the standard evaluation index of myocardial infarction area. In this study, the measurement of myocardial infarction area, the maximum CPK of group P is higher than that of group C (843 (623~1780) vs 763 [510-1030] U/L , P=041) (Figure 2A), indicating that the infarct size of group P is significantly different from that of group C. Recent studies have shown that inflammatory markers, such as CRP and IL-6, are more important than the maximum CPK in assessing the area of ​​myocardial infarction, but this study did not observe a significant difference (Figure 2B); due to the maximum CPK in the two groups The IL-6 value was corrected. In order to evaluate the actual inflammatory response after myocardial infarction (MI), the IL-6/maximum CPK of each patient was calculated as a new indicator (Figure 2C), and the P group took Polyprene The IL-6/max CPK at 8 days after zinc was significantly lower than that of group C (0.024 [0.003-0.066] vs. 0.076 [0.015-0.212], respectively), indicating that polyprezinc has an inhibitory effect on the inflammatory response after AMI .

  Figure 2 Evaluation of inflammatory factors

  3. Although there was no difference between LVDd (Figure 3A) and LVDs (Figure 3B), echocardiography showed that the ejection fraction (EF) of patients in group C did not increase significantly after 3-9 months after AMI (53[49- 60.8] and 59.5[52-69.3]; P=0.015) (Figure 3C). In contrast, echocardiography showed that the ejection fraction (EF) of group P increased significantly from day 3 to month 9 after myocardial infarction (54[51-57] and 62[55-71]%, respectively; P<0.01 ) (Figure 3C), which may indicate that polyprezinc can reduce myocardial damage.

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