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Rivista sulle Malattie del Cuore e dei Vasi
Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752
Minerva Cardioangiologica 2014 October;62(5):389-97
Effects of verapamil and adenosine in an adjunct to tirofiban on resolution and prognosis of noreflow phenomenon in patients with acute myocardial infarction
Faruk Akturk I. 1, Arif Yalcin A. 1, Biyik I. 2, Sarikamis C. 3, Turhan Caglar N. 4, Erturk M. 1, Celik O. 1, Uzun F. 5, Murat Caglar I. 6, Oner E. 1 ✉
1 Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey;
2 Department of Cardiology, Usak State Hospital, Usak, Turkey;
3 Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey;
4 Istanbul Education and Research Hospital, Istanbul, Turkey;
5 Department of Cardiology, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery, Training and Research Hospital, Istanbul, Turkey;
6 Dr Sadi Konuk Education and Research Hospital, Istanbul, Turkey
AIM: We aimed to investigate the effects of verapamil and adenosine in an adjunct to intravenous tirofiban on management and prognosis of no-reflow phenomenon during primary percutaneous coronary intervention (PPCI) and to compare their efficacies on reversing of no-reflow phenomenon and short and midterm survival.
METHODS: We included 46 patients with acute ST-segment elevation myocardial infarction (STEMI) and occurrence of no-reflow phenomenon after PPCI. All patients received intravenous tirofiban and then randomized into one of the following 3 groups: intracoronary adenosine (N.=16), intracoronary verapamil (N.=15) or placebo (N.=15).
RESULTS: Intracoronary verapamil therapy had significant effect in restoring impaired coronary blood flow by decreasing thrombolysis in myocardial infarction (TIMI) frame count from 73±44 to 52±48 (P=0.024). However, adenosine and serum physiologic administration were not found to be so effective in decreasing TIMI frame count (from 81±35 to 71±46, P=0.084; from 74±32 to 71±37, P=0.612, respectively). In-hospital and 6-month survival rates were similar among groups.
CONCLUSION: In conclusion, intracoronary verapamil restored the impaired coronary blood flow more effectively than adenosine or placebo. However, none of them has changed the clinical course in the first 6 months.