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

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Zahid, Jawad Ahmad ; Isbrand, Anders ; Kleif, Jakob ; Schou-Pedersen, Anne-Marie Voigt ; Lykkesfeldt, Jens ; Madsen, Michael Tvilling ; Gögenur, Ismail. / The effect of melatonin on endothelial dysfunction in patients after acute coronary syndrome : The MEFACS randomized clinical trial. In: Journal of Pineal Research. 2019 ; pp. e12600.

Bibtex

@article{a697d2d95ea1484cb9932c074fd50b17,
title = "The effect of melatonin on endothelial dysfunction in patients after acute coronary syndrome: The MEFACS randomized clinical trial",
abstract = "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.",
author = "Zahid, {Jawad Ahmad} and Anders Isbrand and Jakob Kleif and Schou-Pedersen, {Anne-Marie Voigt} and Jens Lykkesfeldt and Madsen, {Michael Tvilling} and Ismail G{\"o}genur",
note = "This article is protected by copyright. All rights reserved.",
year = "2019",
month = "7",
day = "29",
doi = "10.1111/jpi.12600",
language = "English",
pages = "e12600",
journal = "Journal of Pineal Research",
issn = "0742-3098",
publisher = "Wiley-Blackwell Munksgaard",

}

RIS

TY - JOUR

T1 - The effect of melatonin on endothelial dysfunction in patients after acute coronary syndrome

T2 - The MEFACS randomized clinical trial

AU - Zahid, Jawad Ahmad

AU - Isbrand, Anders

AU - Kleif, Jakob

AU - Schou-Pedersen, Anne-Marie Voigt

AU - Lykkesfeldt, Jens

AU - Madsen, Michael Tvilling

AU - Gögenur, Ismail

N1 - This article is protected by copyright. All rights reserved.

PY - 2019/7/29

Y1 - 2019/7/29

N2 - 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.

AB - 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.

U2 - 10.1111/jpi.12600

DO - 10.1111/jpi.12600

M3 - Journal article

SP - e12600

JO - Journal of Pineal Research

JF - Journal of Pineal Research

SN - 0742-3098

ER -

ID: 57670411