Effect of intracoronary verapamil on coronary flow,myocardial perfusion and clinical outcome during percutaneous coronary intervention for acute myocardial infarction
- VernacularTitle:冠状动脉内应用维拉帕米对急性心肌梗死急诊介入治疗后冠状动脉灌注、心肌灌注和临床预后的影响
- Author:
Zhiqing QIAO
;
Ju PU
;
Song DING
- Publication Type:Journal Article
- Keywords:
Verapamil;
Myocardial infarction;
Angioplasty,transluminal,percutaneous coronary;
Myocardial reperfusion
- From:
Chinese Journal of Interventional Cardiology
1996;0(04):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the effects of intracoronary verapamil on coronary flow,myocardial perfusion and clinical outcome during primary percutaneous coronary intervention(PCI) for acute ST elevation myocardial infarction(STEMI).Methods A total of 99 consecutive STEMI patients undergoing primary PCI were randomly assigned to receive intracoronary verapamil or intracoronary heparinised saline immediately after stent deployment.Coronary flow was assessed by Thrombolysis in Myocardial Infarction(TIMI) flow grade(TFG) and corrected TIMI frame count(CTFC),and myocardial perfusion was assessed by TIMI myocardial perfusion grade(TMPG) and TIMI myocardial blush grades(MBG).Coronary and myocardial perfusion were assessed before and after PCI,as well as after drug administration by two doctors independently.Echocardiography were performed one week after PCI.Incidence of major adverse cardiac events in hospital and 3 months follow-up were compared between the two groups.Results Eight patients were excluded from the final analysis.Among the remaining 91 patients,47 patients were in the verapamil group and 44 patients were in control group.Baseline characteristics and angiographic characteristics were not significantly different between the two groups.CTFC,TFG,TMPG,and MBG before and after PCI were of no significant differences between the two groups.However,after drug administration,the verapamil group showed better outcome compared with the control group in CTFC(27.1?14.2 vs 39.0?23.8,P=0.011),TFG≥2(100% vs 90.9%,P=0.035),MBG≥2(91.5%% vs 75.5%,P=0.034),and TMPG≥2(89.4% vs 72.7%,P=0.042).LVEF measured by echocardiography was not significantly different between the two groups one week after PCI.The combined incidence of MACE in hospital(4.3% vs 9.1%,P=0.613) and at 3-month follow-up(23.9% vs 22.7%,P=0.894) was similar between the verapamil group and the control group.Conclusion Intracoronary administration of verapamil can improve coronary flow and myocardial perfusion in STEMI patients underwent primary PCI but show no obvious improvement in short-time clinical prognosis.
