Rotigaptide protects the myocardium and arterial vasculature from ischaemia reperfusion injury

Christian M. Pedersen*, Sowmya Venkatasubramanian, Henrik Vase, Janus A. Hyldebrandt, Hussain Contractor, Michael R. Schmidt, Hans Erik Bøtker, Nicholas L. Cruden, David E. Newby, Rajesh K. Kharbanda, Ninian N. Lang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim Ischaemia-reperfusion injury (IRI) causes impaired endothelial function and is a major component of the adverse effects of reperfusion following myocardial infarction. Rotigaptide increases gap junction conductance via connexin-43. We tested the hypothesis that rotigaptide reduces experimental myocardial infarction size and ameliorates endothelial IRI in humans. Methods Myocardial infarction study: porcine myocardial infarction was achieved by catheter-induced occlusion of the left anterior descending artery. In a randomized double-blind study, rotigaptide (n = 9) or placebo (n = 10) was administered intravenously as a 10 min bolus prior to reperfusion and continuously during 2 h of reperfusion. Myocardial infarction size (IS) was assessed as proportion of the area at risk (AAR). Human translational study: forearm IRI was induced in the presence or absence of intra-arterial rotigaptide. In a randomized double-blind study, forearm arterial blood flow was measured at rest and during intra-arterial infusion of acetylcholine (5-20 μg min-1; n = 11) or sodium nitroprusside (2-8 mg min-1; n = 10) before and after intra-arterial infusion of placebo or rotigaptide, and again following IRI. Results Myocardial infarction study: Rotigaptide treatment was associated with a reduction of infarct size (IS/AAR[%]: 18.7 ± 4.1 [rotigaptide] vs. 43.6 ± 4.2 [placebo], P = 0.006). Human translational study: Endothelium-dependent vasodilatation to acetylcholine was attenuated after ischaemia-reperfusion in the presence of placebo (P = 0.007), but not in the presence of rotigaptide (P = NS). Endothelium-independent vasodilatation evoked by sodium nitroprusside was unaffected by IRI or rotigaptide (P = NS). Conclusions Rotigaptide reduces myocardial infarction size in a porcine model and protects from IRI-related endothelial dysfunction in man. Rotigaptide may have therapeutic potential in the treatment of myocardial infarction.

Original languageEnglish
Pages (from-to)1037-1045
Number of pages9
JournalBritish Journal of Clinical Pharmacology
Issue number6
Publication statusPublished - 1 Jun 2016


  • blood flow
  • endothelium
  • myocardial infarction
  • pharmacology
  • reperfusion


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