- Question
- Can a single dose of cyclosporine given before reperfusion improve clinical outcomes and prevent adverse left ventricular remodeling in patients with acute myocardial infarction?
- Design
- Multicenter, randomized, double-blind, placebo-controlled trial enrolling 970 patients. The primary outcome was assessed at 1 year.
- Population
- Patients with acute anterior ST-segment elevation myocardial infarction referred for primary PCI within 12 hours of symptom onset and with complete occlusion of the culprit coronary artery.
- Intervention
- A single intravenous bolus of cyclosporine at a dose of 2.5 mg/kg, given before coronary recanalization.
- Control
- A single intravenous bolus of matching placebo, given before coronary recanalization.
- Primary outcome
- Composite of death from any cause, worsening of heart failure during the initial hospitalization, rehospitalization for heart failure, or adverse left ventricular remodeling at 1 year (increase of 15% or more in left ventricular end-diastolic volume).
- Results
- The primary outcome occurred in 59.0% of the cyclosporine group and 58.1% of the control group (OR 1.04; 95% CI 0.78 to 1.39; P=0.77). Cyclosporine also did not reduce the individual clinical components of the primary outcome or other events such as recurrent infarction, unstable angina, or stroke.
- Safety
- No significant difference in the safety profile was observed between the two groups.
- Conclusion
- In patients with anterior STEMI undergoing primary PCI, intravenous cyclosporine did not improve clinical outcomes or prevent adverse left ventricular remodeling at 1 year compared with placebo.
- Why it matters
- This neutral trial did not support cyclosporine as a cardioprotective strategy against reperfusion injury, despite experimental rationale and earlier smaller studies.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026