Salvage of ischemic myocardium by ibuprofen during infarction in the conscious dog

Because nonsteroidal anti-inflammatory drugs differ in potency and degree of prostaglandin inhibition, they may have different effects on ischemic myocardium. The effect of ibuprofen, an agent of this type, on myocardial infarct size was measured 2 days after occlusion of the left circumflex coronary artery in conscious dogs. Treatment was randomized in dogs after occlusion: Intravenous infusions of ibuprofen (6.25 mg/kg per hour) were administered to 13 dogs and saline solution (0.9 percent) to 13 control dogs over a period of 6 hours. The boundary of the occluded coronary bed, or anatomic risk region, was defined by postmortem coronary arteriography. Masses of infarct and occluded bed were measured by planimetry of weighed transverse sections of the left ventricle. Ibuprofen decreased infarct size compared with that in control dogs, both as percent of the left ventricle (mean ± standard error of the mean 7.5 ± 1.4 versus 15.2 ± 3.1, p < 0.05) and as percent of the occluded bed (16.3 ± 2.3 versus 38.6 ± 5.7, p < 0.005). Ibuprofen also altered (p < 0.001) the relation between the size of the infarct and the size of the occluded bed, so that hearts with occluded beds of similar size had smaller infarcts than those of control dogs. Morphologically, ibuprofen salvaged myocardium in both lateral and epicardial regions of the occluded bed. Changes in arterial pressure, left atrial pressure and heart rate were similar in the two groups. Changes in regional myocardial blood flow measured with 7 to 9 μm radioactive microspheres were also similar in both groups, with an increase in flow to infarcted regions and borders between 20 seconds to 15 minutes after occlusion, but no further change from 15 minutes to 6 hours. Thus, protection of ischemic myocardium by ibuprofen was not due to changes in collateral flow or myocardial oxygen demands, suggesting that cellular and metabolic effects might be important.