Medication to Lessen Heart Attack Damage Clears Trial

A new, under trial medication that helps lessen muscle damage to the heart following cardiac arrest has cleared safety tests at the Duke Clinical Research Institute. Results of the first test on humans have been published online in the journal Circulation.

The new drug KAI-9803 works by blocking the activity of an enzyme called delta protein kinase C. This enzyme is responsible for cell and tissue death following percutaneous coronary intervention (PCI), a set a procedures that include balloon angioplasty and stent placement for propping and opening clogged coronary blood vessels that can lead to a heart attack. This process of restoring blood flow to the heart is known as reperfusion.

For their study christened DELTA-MI, researchers led by Dr. Matthew Roe selected 154 patients who were eligible for PCI following heart attacks. These patients were randomly distributed into five groups, four of which each received different doses of KAI-9803 while the last group was administered a placebo. PCI was administered to all patients by injecting the drug directly into their coronary blood vessels.

“The goal of the treatment is to flood the heart damaged by the heart attack with the drug immediately before blood flow is restored and then again, immediately afterwards,” Dr. Roe said. “We believe that bathing the area with this novel compound may block the damaging cascade of events that are triggered specifically by delta protein kinase C when blood is restored to the heart muscle.”

While the trial was not targeted at evaluating the efficacy of KAI-9803, the researchers found promising results. “We’ve needed something like this for a long time,” said Dr. Roe. This was in tune with previous studies on animals that found KAI-9803 lessened damage to the heart muscle and quickly restored pumping functionality.

In Dr. Roe’s opinion, most people are unaware of the fact that the heart suffers damage twice during a heart attack – first when blockage in an artery prevents blood and oxygen from reaching the heart; and a second time when PCI is administered and blood flow is restored through reperfusion. “We may not be able to intervene in the first stage of a heart attack, but we think there may be ways to limit damage caused by reperfusion injury,” he said.

“We designed the DELTA-MI trial to find out if KAI-9803 is safe for humans, and we accomplished that goal; we did not see any serious side effects,” said Dr. Roe. “We also found, however, many promising signs of beneficial drug activity such as lessened damage to the heart muscle and improvement in electrical conductivity in the heart that corresponded to restoration of blood flow to the heart muscle. As a result, we feel this drug has the potential to be helpful in reducing the impact of a heart attack in humans.”

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