ORIGINAL ARTICLES   

Minerva Cardioangiologica 2014 October;62(5):389-97

Copyright © 2014 EDIZIONI MINERVA MEDICA

language: English

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.