Cyclosporine in Acute Myocardial Infarction Complicated by Cardiogenic Shock

Inclusion Criteria:

• Patients ( male or female), aged over 18, without any legal protection measure

• Having a health coverage

• Presenting within 12 hours of the onset of chest pain, with a ST segment elevation ornon ST elevation and for whom the clinical decision was made to treat withpercutaneous coronary intervention (PCI) primary or rescue

• Occlusion of culprit coronary artery (TIMI flow grade = 0 or 1) at the time ofadmission in the catheterism laboratory

• Patient presenting a cardiogenic shock defined by a SBP<90mmhg for a period over 30minutes and do not answering to a test of vascular charge associated with signsperipheral hypoperfusion (cold extremities, cyanosis, oliguria with urine output <50ml/h or alteration of higher mental functions).

• Clear information is delivered to the patient or a legal representative if present andpreliminary oral consent obtained, followed by obtaining written consent signed assoon as possible, in accordance with ICH. NB: Patients undergoing either primary PCI or rescue PCI are eligible for the study. Patients with previous AMI, PCI or coronary artery bypass surgery (CABG) are eligible forthe study.

Exclusion Criteria:

• TIMI flow grade >1

• Patients in cardiac arrest

• Patients with mechanical complication of myocardial infarction at admission (septal,broken pillar cracking or myocardial rupture, tamponade).

• Patients with other causes of hemodynamic shock: hemorrhagic, septic or anaphylactic.

• Patients with known hypersensitivity to cyclosporine, hypersensitivity to egg, peanutor Soya-bean proteins

• Renal insufficiency (either known creatinine clearance < 30 ml/min/1.73m² or currentmedical care for severe renal insufficiency)

• Patients treated with any compound containing Hypericum perforatum (St. John's Wort)or Stiripentol or Aliskiren or Bosentan or Rosuvastatine

• Female patients currently pregnant or women of childbearing age who were not usingcontraception (oral diagnosis).

• Patients with any disorder associated with immunological dysfunction more recentlythan 6 months prior to presentation, cancer, lymphoma, known positive serology forHIV, or hepatitis

• Participation to another clinical trial