Intravenous dexrazoxane for haemorrhagic myocardial infarction: the SHIELD-MI study
Authors' conclusion
Peri-procedural intravenous DXZ was associated with lower IMH and infarct size and higher LVEF, without safety concerns.
Study context
- Population
- Patients with reperfused ST-elevation myocardial infarction (STEMI) undergoing primary PCImatched analytic cohort
- Participants
- 50 patients
- Comparison
- IV dexrazoxane vs matched placebo-treated comparators
- Dexrazoxane (DXZ)n = 25
- Comparatorsn = 25reference
- Primary endpoint
- LVEF and IMH volume on CMR (fixed-sequence)
- Follow-up
- 48-72 h
Methodological detailssingle-centre, placebo-controlled, sequential-cohort, matched comparators, participants and cardiac MRI (CMR) core laboratory blinded, prespecified fixed-sequence testing
- Single-centre
- Placebo-controlled
- Sequential-cohort
- Matched comparators
- Participants and CMR core laboratory blinded
- Prespecified fixed-sequence testing
Primary result
As reported in the abstract
| Group | Left ventricular ejection fraction (LVEF) | Intramyocardial hemorrhage (IMH) volume |
|---|---|---|
| DXZ | 39.8±7.7% | 2.0±3.4% LV |
| Comparators | 34.7±10.1% | 6.3±6.0% LV |
Left ventricular ejection fraction (LVEF)
DXZ39.8±7.7%
Comparators34.7±10.1%
Intramyocardial hemorrhage (IMH) volume
DXZ2.0±3.4% LV
Comparators6.3±6.0% LV
- DXZ vs Comparators: P = 0.048 — LVEF
- DXZ vs Comparators: P = 0.004 — IMH volume
Further findings
Infarct size on CMR · 48-72 h
P = 0.002
- Infarct size on CMR: matched cohort (n=50)
Hemorrhagic MI
- Hemorrhagic MI in 6/25 (24%) vs 16/25 (64%) participants (DXZ vs comparators)
- P = 0.010
- Matched cohort (n=50)
Safety
- No drug-related serious adverse events observed
Original publication
Intravenous dexrazoxane for haemorrhagic myocardial infarction: the SHIELD-MI study. Eur Heart J. Published 31 August 2026. doi:10.
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