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- W2125488506 abstract "The interesting study by Bernik et al. reported that exenatide in patients with primary percutaneous coronary intervention (pPCI) showed a trend towards a smaller infarction size [ [1] Bernink F.P. Timmers L. Diamant M. et al. Effect of additional treatment with EXenatide in patients with an Acute Myocardial Infarction: The EXAMI study. Int J Cardiol. 2012; 167: 289-290 Abstract Full Text Full Text PDF PubMed Scopus (35) Google Scholar ]. The results of the study are somewhat comparable to another study which also reported the reduction of final infarct size/area-at-risk (AAR) and improvement of myocardial salvage index by continuous intravenous exenatide infusion in STEMI patients [ [2] Lønborg J. Vejlstrup N. Kelbæk H. et al. Exenatide reduces reperfusion injury in patients with ST-segment elevation myocardial infarction. Eur Heart J. 2012; 33: 1491-1499 Crossref PubMed Scopus (429) Google Scholar ]. We'd like to comment this discrepancy. First, administrating dose and route of exenatide are very important. The authors state that just prior to the coronary angiogram, a loading dose of 5 μg exenatide was administered intravenously in 30 min, followed by a continuous infusion of 20 μg/24 h for the duration of 72 h. We think that the dose of exenatide is relatively small and infusion time is long, especially at reperfusion therapy time. Experimental drug must be administered prior to the restoration of blood flow with most higher dose during the reperfusion therapy because myocardial ischemia–reperfusion injury occurs in the first few minutes of coronary artery reperfusion. In the clinical setting, use of exenatide is 10 μg twice daily via subcutaneous injections for treatment of patients with diabetes. We could not be sure whether only exenatide conventional dose injections would be enough to provide cardioprotection. In large animal model of IR injury, 10 μg intravenous bolus and 10 μg subcutaneous simultaneous injections of exenatide reduced myocardial infarct size and prevented deterioration of systolic and diastolic cardiac functions [ [3] Timmers L. Henriques J.P. de Kleijn D.P. et al. Exenatide reduces infarct size and improves cardiac function in a porcine model of ischemia and reperfusion injury. J Am Coll Cardiol. 2012; 53: 501-510 Crossref Scopus (387) Google Scholar ]. We recommend that exenatide must be treated with 10 μg subcutaneous and more than 10 μg intravenous bolus injections simultaneously 5–10 min before the onset of reperfusion in future larger trial." @default.
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- W2125488506 date "2013-10-01" @default.
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- W2125488506 title "Do exenatide truly improve the myocardial infarction size?" @default.
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- W2125488506 doi "https://doi.org/10.1016/j.ijcard.2013.04.013" @default.
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