Effects of Doxycycline on Left Ventricular Remodeling in Patients With Acute Anterior Myocardial Infarction Uundergoing Primary Angioplasty: A Randomized Clinical Trial

Background: Inflammatory mechanisms can cause left ventricular (LV) remodeling. These mechanisms include increased matrix metalloproteinases and the tissue inhibitors of metalloproteinases. Doxycycline is an antibiotic (macrolide) and a broad inhibitor of matrix metalloproteinases. This study evaluated the effects of early short-term doxycycline treatment on LV remodeling in patients suffering from ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods: In the present double-blinded randomized control trial, 68 post-MI patients who underwent primary PCI for STEMI were assigned to 2 groups, each consisting of 34 volunteers. Over a 7- day period, all these volunteers took 100 mg of Doxycycline twice a day. A placebo with the same order was prescribed for the control group. The cardiac function, the LV diameter, the left atrial diameter, and the LV torsion were measured at baseline and 40 days afterward. Results: The mean age of the control and experimental groups was 53.7 years and 56.1 years, respectively. The averages of the left atrial volume (P = 0.03), the LV end-diastolic volume (P = 0.03), and the LV end-systolic volume (P = 0.01) in the experimental group rose less significantly than those in the control group. However, the LV torsion such as basal rotation (P = 0.03), apical rotation (P = 0.02), twist (P = 0.02), and torsion (P = 0.002) increased more substantially in the experimental group than in the control group. Conclusions: Early administration of doxycycline attenuated LV remodeling measured by speckletracking echocardiography in our patients with anterior STEMI after primary PCI, vs. our control group subjects, who were on a placebo diet.