OBJECTIVE Myocardial infarction (MI) is one of the leading causes of death in the world. Early myocardial reperfusion improves acute MI survival. Bioflavonoid quercetin is known to have antioxidant, anti-inflammatory, and antiproliferative properties. The presented pilot study aims to investigate the cardioprotective effect of quercetin on infarct size limiting in patients with ST-segment elevation myocardial infarction (STEMI).
METHODS Patients (n ¼ 143) with first anterior STEMI within 6 hours from symptoms onset were included in this openlabel multicenter pilot study. Patients were randomized either into quercetin group (n ¼ 70) in addition to standard treatment or recommended therapy alone group (control group, n ¼ 73). Quercetin infusions were initiated before reperfusion and repeated during the next 5 days. The infarct size assessed using creatine kinase-myocardial band area under curve (CK-MB AUC) was the primary study outcome.
RESULTS The study arms did not differ in demographics, time to admission, and main clinical data. The median early CKMB AUC was significantly lower in quercetin group than in controls (8036 7594 vs 11219 8146 U 1 h/L, p ¼ 0.015). Intravenous quercetin administration was associated with less reperfusion-induced intramyocardial hemorrhage by Cardiac Magnetic Resonance on Day 3 (11.1% of patients in quercetin group vs 53.3% of patients in control group, p < 0.024). There were no significant differences in left ventricle ejection fraction and LV remodeling indicators.
CONCLUSION Our pilot study is the first to demonstrate novel insight into ischemia/reperfusion damage in STEMI patients. The addition of quercetin to standard STEMI therapy limits infarct size and prevents intramyocardial hemorrhage after the first anterior STEMI. Further research will be necessary to both validate and expand upon these findings. (Hellenic Journal of Cardiology 2024;76:68–74) © 2023 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).