No Reduced Risk by Taking MC-1 after Surgery

Photo: Surgerons in an operating room

Heart attack can be a complication
after CABG surgery; © NCI Visuals

Serious complications of CABG surgery can include heart attack, kidney insufficiency, stroke, and death. Phase 2 trial data suggest that MC-1 may reduce death or heart attack in high-risk patients undergoing CABG surgery.

John H. Alexander, M.D., M.H.S., of Duke University Medical Center, Duke Clinical Research Institute, Durham, N.C., and colleagues with MEND-CABG II, a phase 3, multicenter, randomized trial, assessed the cardioprotective effect of MC-1 administered before and continued for 30 days after CABG surgery, compared with placebo, in 3,023 intermediate- to high-risk patients undergoing CABG surgery with cardiopulmonary bypass.

The researchers found that the primary efficacy outcome, cardiovascular death or nonfatal heart attack at 30 days, occurred in 140 of 1,510 patients (9.3 percent) in the MC-1 group and 133 of 1,486 patients (9.0 percent) in the placebo group. All-cause death was higher among patients assigned to MC-1 than placebo at 4 days (1.0 percent vs. 0.3 percent) but was similar at 30 days (1.9 percent vs. 1.5 percent). There was no beneficial effect of MC-1 seen in any prespecified subgroup or on other outcomes.

There was no difference in the incidence of postoperative stroke, atrial fibrillation, or kidney function between the two groups. Patients assigned to receive MC-1 and placebo had similar intensive care unit and hospital lengths of stay. “MEND-CABG II demonstrates that among intermediate- to high-risk patients undergoing CABG surgery, MC-1, 250 mg/d, given immediately before and for 30 days following surgery did not reduce cardiovascular death or nonfatal [heart attack]. Myocardial injury remains a significant problem following CABG surgery. Effective therapies to reduce perioperative morbidity and mortality are needed but remain elusive,” the authors conclude.; Source: JAMA and Archives Journals