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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

The effect of melatonin on endothelial dysfunction in patients after acute coronary syndrome: The MEFACS randomized clinical trial

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  • Jawad Ahmad Zahid
  • Anders Isbrand
  • Jakob Kleif
  • Anne-Marie Voigt Schou-Pedersen
  • Jens Lykkesfeldt
  • Michael Tvilling Madsen
  • Ismail Gögenur
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Endothelial dysfunction (ED) precedes acute coronary syndrome. Oxidative stress results in ED but is reversible. Melatonin is aside from being a circadian hormone also an antioxidant. The aim of this study was to investigate if 25 mg melatonin administered for twelve weeks following acute coronary syndrome (ACS) could improve ED. In this placebo-controlled randomized trial, ED was measured as reactive hyperaemia index (RHI) at baseline, day 14, and 84. The effect was assessed using a generalized estimating equation adjusted for the baseline RHI. As secondary outcome, the concentrations of three biomarkers were measured: L-arginine, asymmetric dimethylarginine, and uric acid. Thirty-one patients were included in the study. The intention-to-treat analysis of the primary outcome had 26 patients due to missing data. The estimated marginal mean difference in RHI at day 14 and 84 between the groups was 0.15 (95% CI: 0.29 - 0.01, p=0.039) in favor of the placebo group. No significant differences in the biomarker concentrations were found. Melatonin treatment after ACS did not improve but may have aggravated ED. The significant difference between groups was in favor of placebo, but this might be due to the effect of missing data or uneven distribution of comorbidities. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalJournal of Pineal Research
Pages (from-to)e12600
ISSN0742-3098
DOIs
Publication statusE-pub ahead of print - 29 Jul 2019

ID: 57670411