Paroxetine fails to improve LVEF after anterior MI: JAMA

Left ventricular remodeling following acute myocardial infarction often causes progressive myocardial dysfunction and adversely affects prognosis.

A study was conducted by Pilgrim T et. al to investigate the efficacy of paroxetine-mediated G-protein–coupled receptor kinase 2 inhibition to mitigate adverse left ventricular remodeling in patients presenting with acute myocardial infarction.

This study was double-blind, placebo-controlled a randomized clinical trial that was conducted at Bern University Hospital, Bern, Switzerland. Patients with acute anterior ST-segment elevation myocardial infarction with left ventricular ejection fraction (LVEF) of 45% or less was randomly allocated to 2 study arms between October 26, 2017, and September 21, 2020.

The authors selected a total of 50 patients with acute anterior myocardial infarction, of whom 38 patients underwent cardiac magnetic resonance imaging both at baseline and 12 weeks. These patients were randomly divided into either paroxetine orally for 12 weeks group or to the placebo group.

The primary endpoint was the difference in the patient-level improvement of LVEF between baseline and 12 weeks as assessed by cardiac magnetic resonance tomography. While secondary endpoints were changes in left ventricular dimensions and late gadolinium enhancement between baseline and follow-up.

The results of the study are as follows:

• There was no difference in the recovery of LVEF between the experimental group and the control group or changes in left ventricular end-diastolic volume and end-systolic volume.
• Late gadolinium enhancement as a percentage of the total left ventricular mass decreased to a larger extent in the experimental group compared with the control group.

The researchers concluded that in this trial, treatment with paroxetine did not improve LVEF after myocardial infarction compared with placebo.

Reference:

Effect of Paroxetine-Mediated G-Protein Receptor Kinase 2 Inhibition vs Placebo in Patients With Anterior Myocardial Infarction by Pilgrim, T et. al published in the JAMA Cardiol.

doi:10.1001/jamacardio.2021.2247