Volume 2014, Issue 3
  • ISSN: 2305-7823
  • EISSN:


The NAIMI trial has recently been published. It assessed one of the most contemporary and challenging issues in the management of acute myocardial infarction (AMI), namely prevention of reperfusion injury (RPI) after primary PCI for ST-elevation myocardial infarction (STEMI). It investigated the effect of the intravenous administration of Na nitrite given immediately prior to primary PCI for STEMI in 229 patients (118 in the treatment group, and 111 in placebo). The myocardial infarction (MI) size did not differ between the two groups as observed by cardiac MRI (CMR) with gadolinium enhancement at 6–8 days or plasma Troponin-I and creatine kinase (CK), or by left ventricular (LV) volume and ejection fraction (EF) as measured by echocardiography at 6–8 days and again at 6 months. They concluded that IV nitrites did not reduce the infarct size. There was, however, a trend towards benefit in diabetic patients in the post-hoc analysis. The small number of these subjects has probably lead to inconclusive outcome in this subset.


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  1. Huynh T, Perron S, O'Loughlin J, Joseph L, Labrecque M, Tu JV, Théroux P. Comparison of primary percutaneous coronary intervention and fibrinolytic therapy in ST-segment-elevation myocardial infarction: Bayesian hierarchical meta-analyses of randomized controlled trials and observational studies. Circulation. 2009; 119:24:31013109.
    [Google Scholar]
  2. Bainey KR, Armstrong PW. Clinical perspectives on reperfusion injury in acute myocardial infarction. Am Heart J. 2014 May; 167:5:637645.
    [Google Scholar]
  3. Heidenreich PA, Albert NM, Allen LA. Forecasting the impact of heart failure in the United States: A policy statement from the American Heart Association. Circ Heart Fail. 2013 May; 6:3:606619.
    [Google Scholar]
  4. Hendgen-Cotta UB, Merx MW, Shiva S, Schmitz J, Becher S, Klare JP, Steinhoff HJ, Goedecke A, Schrader J, Gladwin MT, Kelm M, Rassaf T. Nitrite reductase activity of myoglobin regulates respiration and cellular viability in myocardial ischemiareperfusion injury. Proc Natl Acad Sci USA. 2008; 105::1025610261.
    [Google Scholar]
  5. Siddiqi N, Neil C, Bruce M, MacLennan G, Cotton S, Papadopoulou S, Feelisch M, Bunce N, Lim PO, Hildick-Smith D, Horowitz J, Madhani M, Boon N, Dawson D, Kaski JC, Frenneaux M, NIAMI investigators . Intravenous nitrite in acute ST-elevation myocardial infarction: A randomized controlled trial (NIAMI). Eur Heart J. 2014; 35::12551262.
    [Google Scholar]
  6. Bøtker HE, Kharbanda R, Schmidt MR, Bøttcher M, Kaltoft AK, Terkelsen CJ, Munk K, Andersen NH, Hansen TM, Trautner S, Lassen JF, Christiansen EH, Krusell LR, Kristensen SD, Thuesen L, Nielsen SS, Rehling M, Sørensen HT, Redington AN, Nielsen TT. Remote ischaemic conditioning before hospital admission, as a complement to angioplasty, and effect on myocardial salvage in patients with acute myocardial infarction: A randomised trial. Lancet. 2010; 375::727734.
    [Google Scholar]
  7. Gonzalez FM, Shiva S, Vincent PS, Ringwood LA, Hsu LY, Hon YY, Aletras AH, Cannon RO 3rd, Gladwin MT, Arai AE. Nitrite anion provides potent cytoprotective and antiapoptotic effects as adjunctive therapy to reperfusion for acute myocardial infarction. Circulation. 2008; 117::29862994.
    [Google Scholar]
  8. Jones DA, Andiapen M, Van-Eijl TJ, Webb AJ, Antoniou S, Schilling RJ, Ahluwalia A, Mathur A. The safety and efficacy of intracoronary nitrite infusion during acute myocardial infarction (NITRITE-AMI): Study protocol of a randomized controlled trial. BMJ open. 2013; 3:4, pii: e002813. doi: 10.1136/bmjopen-2013-002813. Print 2013.
    [Google Scholar]
  9. Kouvaras G, Cokkinos D, Spyropoulou M. Increased mortality of diabetics after acute myocardial infarction attributed to diffusely impaired left ventricular performance as assessed by echocardiography. Jpn Heart J. 1988; 29:1:19.
    [Google Scholar]
  10. Piot C, Croisille P, Staat P, Thibault H, Rioufol G, Mewton N, Elbelghiti R, Cung TT, Bonnefoy E, Angoulvant D, Macia C, Raczka F, Sportouch C, Gahide G, Finet G, André-Fouët X, Revel D, Kirkorian G, Monassier JP, Derumeaux G, Ovize M. Effect of cyclosporine on reperfusion injury in acute myocardial infarction. N Engl J Med. 2008; 359:5:473481.
    [Google Scholar]
  11. Erlinge D, Götberg M, Lang I, Holzer M, Noc M, Clemmensen P, Jensen U, Metzler B, James S, Bötker HE, Omerovic E, Engblom H, Carlsson M, Arheden H, Ostlund O, Wallentin L, Harnek J, Olivecrona GK. Rapid endovascular catheter core cooling combined with cold saline as an adjunct to percutaneous coronary intervention for the treatment of acute myocardial infarction. The CHILL-MI trial: A randomized controlled study of the use of central venous catheter core cooling combined with cold saline as an adjunct to percutaneous coronary intervention for the treatment of acute myocardial infarction. J Am Coll Cardiol. 2014; 63:18:18571865.
    [Google Scholar]
  12. Goor DA, Mohr R, Lavee J. Enhanced protection of myocardial function by systemic deep hypothermia during cardioplegic arrest in multiple coronary bypass grafting. J Thorac Cardiovasc Surg. 1982 Aug; 84:2:237242.
    [Google Scholar]
  • Article Type: Research Article
Keyword(s): nitritesprimary PCIreperfusion injury and ST-elevation myocardial infarction
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