MC-1 (pyridoxal 5'-phosphate): novel therapeutic applications to reduce ischaemic injury.


Journal Article (Review)

Despite the overall efficacy of mechanical reperfusion therapies, such as percutaneous coronary intervention and coronary artery bypass graft surgery, in reducing the morbidity and mortality that is associated with acute ischaemic syndromes, many of the treated patients develop ischaemia-reperfusion injury due to impaired microvascular integrity, embolisation of atherothrombotic debris and/or disrupted end-organ metabolism. MC-1 is an investigational drug from Medicure, Inc. In preclinical models of ischaemia and ischaemia-reperfusion injury, treatment with MC-1 has demonstrated significant cardio- and neuroprotective effects. Although the pharmacological activity of MC-1 may involve multiple mechanisms, research suggests that at least part of the protective effect may be mediated through its actions on purinergic receptors. Early clinical experience with MC-1 also appears to be promising: in a recent Phase II evaluation, treatment with MC-1 was associated with a statistically significant reduction in periprocedural infarct size (as measured by area under the curve creatine kinase-myocardial band) among high-risk patients undergoing elective percutaneous coronary intervention. Based on these findings, larger, randomised trials to confirm the safety and efficacy of MC-1 in the setting of coronary artery revascularisation with coronary artery bypass graft, acute coronary syndromes and stroke are ongoing or in development. These forthcoming evaluations should clarify the safety and efficacy of MC-1 and improve the understanding regarding its potential therapeutic role in a variety of clinical settings and indications.

Full Text

Duke Authors

Cited Authors

  • Kandzari, DE; Dery, J-P; Armstrong, PW; Douglas, DA; Zettler, ME; Hidinger, GK-G; Friesen, AD; Harrington, RA

Published Date

  • November 2005

Published In

Volume / Issue

  • 14 / 11

Start / End Page

  • 1435 - 1442

PubMed ID

  • 16255681

Pubmed Central ID

  • 16255681

Electronic International Standard Serial Number (EISSN)

  • 1744-7658

International Standard Serial Number (ISSN)

  • 1354-3784

Digital Object Identifier (DOI)

  • 10.1517/13543784.14.11.1435


  • eng