Effects of Bempedoic Acid in Acute Myocardial Infarction in Rats: No Cardioprotection and No Hidden Cardiotoxicity

Int J Mol Sci. 2023 Jan 13;24(2):1585. doi: 10.3390/ijms24021585.


Lipid-lowering drugs have been shown to have cardioprotective effects but may have hidden cardiotoxic properties. Therefore, here we aimed to investigate if chronic treatment with the novel lipid-lowering drug bempedoic acid (BA) exerts hidden cardiotoxic and/or cardioprotective effects in a rat model of acute myocardial infarction (AMI). Wistar rats were orally treated with BA or its vehicle for 28 days, anesthetized and randomized to three different groups (vehicle + ischemia/reperfusion (I/R), BA + I/R, and positive control vehicle + ischemic preconditioning (IPC)) and subjected to cardiac 30 min ischemia and 120 min reperfusion. IPC was performed by 3 × 5 min I/R cycles before ischemia. Myocardial function, area at risk, infarct size and arrhythmias were analyzed. Chronic BA pretreatment did not influence cardiac function or infarct size as compared to the vehicle group, while the positive control IPC significantly reduced the infarct size. The incidence of reperfusion-induced arrhythmias was significantly reduced by BA and IPC. This is the first demonstration that BA treatment does not show cardioprotective effect although moderately reduces the incidence of reperfusion-induced arrhythmias. Furthermore, BA does not show hidden cardiotoxic effect in rats with AMI, showing its safety in the ischemic/reperfused heart.

Keywords: acute myocardial infarction; arrhythmias; bempedoic acid; cardioprotection; hidden cardiotoxicity; hyperlipidemia; ischemia/reperfusion injury; nexletol; nilemdo.

MeSH terms

  • Animals
  • Arrhythmias, Cardiac / drug therapy
  • Arrhythmias, Cardiac / etiology
  • Arrhythmias, Cardiac / prevention & control
  • Cardiotoxicity
  • Ischemic Preconditioning, Myocardial*
  • Lipids / therapeutic use
  • Myocardial Infarction* / drug therapy
  • Myocardial Infarction* / prevention & control
  • Myocardial Ischemia*
  • Myocardial Reperfusion Injury* / prevention & control
  • Rats
  • Rats, Wistar


  • 8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid
  • Lipids