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New drug may increase survival rate for major heart attacks

Houston, TX - 8/24/2004

Physicians at the Methodist DeBakey Heart Center are studying a new way to improve the chances of people surviving major heart attacks. 

High levels of nitric oxide released during large heart attacks can cause cardiogenic shock, a dramatic drop in blood pressure that can result in direct damage to the heart muscle and vital organs eventually resulting in death. Cardiogenic shock is the leading cause of death among people treated for heart attacks. Patients whose hearts go into shock during a heart attack have less than a 50 percent chance of survival, while modern treatment for heart attacks not complicated with shock provides greater than 90 percent chance of survival for patients who make it to the hospital.

“People who survive cardiogenic shock after a heart attack usually go on to lead active, functional lives,” said Dr. Vinay Thohan, medical director of multi-organ transplant unit, Methodist DeBakey Heart Center. “The troubling survival statistics with cardiogenic shock challenges me to find better treatments to address this devastating condition.”

Thohan is studying a drug that will prevent the production of nitric oxide in patients in cardiogenic shock. Early results from studies conducted in Europe have been promising, showing improved blood pressure and better blood flow to the kidneys. Thohan is the principle investigator and Methodist is the only site in Texas for this international study, called SHOCK-2. 

Patients are randomly assigned to one of five treatment groups. Four of the five groups will get varying doses of the study medication, called monomethylarginine or L-NMMA, which blocks the excessive production of nitric oxide in the body. The remaining group will receive a placebo. Patients will receive the study medication or placebo intravenously over a period of five hours. The goal of the study is to determine whether L-NMMA, by lowering the amount of nitric oxide, can improve blood pressure and blood flow to vitals organs including the brain, heart and kidneys. 

During the study patients will receive state of the art medical care in the coronary care unit including continuous heart monitoring and medications designed to improve survival from a heart attack. Patients might have had an angioplasty procedure to open the vessel that caused the heart attack.  In addition Thohan closely monitors all patients enrolled in the study and adjusts medications to optimize their chances of survival. 

The Methodist DeBakey Heart Center is one of 30 centers worldwide and the only center in Texas that uses this potentially lifesaving therapy.