Ricerca avanzata

Home > Riviste > Minerva Cardioangiologica > Fascicoli precedenti > Articoli online first > Minerva Cardioangiologica 2016 Jun 01

FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOMINERVA CARDIOANGIOLOGICA

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

Periodicità: Bimestrale

ISSN 0026-4725

Online ISSN 1827-1618

 

Minerva Cardioangiologica 2016 Jun 01

Effect of intracoronary nitroprusside injection time point on flow recovery during primary percutaneous coronary intervention in patients with ST elevation acute myocardial infarction

Lixia YANG 1, Lihua MU 2, Linhui SUN 3, Feng QI 1, Ruiwei GUO 1

1 Department of Cardiology, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan, China; 2 Department of Emergency, Yunnan Provincial Emergency Center, Kunming, Yunnan, China; 3 Department of Medical Control, Kunming General Hospital of Chengdu Military Command, Kunming, Yunnan, China

BACKGROUND: The no/slow reflow phenomenon during primary percutaneous coronary intervention (PPCI) causes the destruction of the coronary microcirculation and further myocardial damage. Some studies have shown that intracoronary nitroprusside infusion is a safe and effective method for managing the no/slow reflow phenomenon. However, it is uncertain whether the injection of nitroprusside at a specific time point during PPCI can most effectively prevent no-reflow. In this study, we investigated the effect of the timing of an intracoronary nitroprusside injection on flow recovery during PPCI in patients with ST elevation acute myocardial infarction (STEMI).
METHODS: One hundred twenty consecutive patients with STEMI who underwent PPCI were enrolled in the study. Patients who fulfilled the eligibility criteria were randomly allocated to three groups: control group (n = 40) received no nitroprusside before they completed PCI; the second group (n = 40) received nitroprusside before balloon dilatation; and the third group (n = 40) received nitroprusside after each balloon dilatation and before contrast agent refilling. The baseline clinical variables and the details of the PCI procedure were collected. The thrombolysis in myocardial infarction (TIMI) flow grades and the corrected TIMI frame count (cTFC) were evaluated immediately after stent implantation was completed.
RESULTS: There were no significant differences in the baseline characteristics, antithrombotic drugs given before PCI, and details of the PCI procedure among the three groups (P > 0.05). The incidence of TIMI grade 3 after PCI was significantly higher in the nitroprusside group than in the control group (P = 0.025), whereas cTFC was significantly lower in the nitroprusside group (26.6 ± 15.2) than in the control group (38.1 ± 21.3, P = 0.001). The incidence of TIMI grade 3 after PCI was significantly higher in the third group than in the second group (P = 0.045), and cTFC was significantly lower in the third group (21.5 ± 9.5) than in the second group (31.2 ± 18.3, P = 0.002). Multivariable linear regression analyses showed that the intracoronary nitroprusside injection time was a significant predictor of cTFC after PCI.
CONCLUSIONS: These data suggest that the intracoronary injection of nitroprusside significantly reduced the incidence of no/slow reflow during PPCI. The intracoronary injection of nitroprusside most effectively prevented the no/slow reflow phenomenon when administered between balloon dilatation and contrast agent refilling during PPCI.

lingua: Inglese


FULL TEXT  ESTRATTI

inizio pagina