We rarely venture into meds, but this one was too interesting to bypass. In case you did not know, sildenafil (tradenamed Viagra) was initially developed as a heart medication. Belonging to a class of meds called phosphodiesterase inhibitors, Viagra was thought by Pfizer to become a heart-supporting drug, like other positive inotropic agents in the same class, namely amrinone and milrinone (used only occasionally, on a rare unstable patient by your correspondent, an anesthesiologist.) Phosphodiesterase inhibitors are known to improve cardiac function, but they also dilate peripheral vasculature, hence they don’t necessarily improve blood pressure, and might even drop it.
New research from Virginia Commonwealth University says that there is a possible benefit in using Viagra and its cousin Levitra in patients with an ongoing MI:
During a heart attack, the heart is deprived of oxygen, which can result in significant damage to heart muscle and tissue. After the attack, most patients require treatment to reduce and repair the damage and improve their chances of survival. With the exception of early reperfusion, there are no available therapies that are truly effective in protecting or repairing such damage clinically.
Rakesh C. Kukreja, Ph.D., professor of medicine and Eric Lipman Chair of Cardiology at VCU, and colleagues compared nitroglycerin with two erectile dysfunction drugs — Viagra®, generically known as sildenafil, and Levitra®, generically known as vardenafil — to determine the effectiveness of each for heart protection following a heart attack. Nitroglycerin is a drug used to treat angina, or chest pain. It is a vasodilator and opens blood vessels in order to improve the flow of blood to a patient’s heart.
The research team reported that in an animal model, sildenafil and vardenafil reduce damage in the heart muscle when given after a severe heart attack. In contrast, nitroglycerin failed to reduce the damage in the heart when administered under similar conditions. The findings were published in the February issue of the Journal of Molecular and Cellular Cardiology, the official publication of the International Society for Heart Research.