Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction |
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作者单位: | Cardiology Department of the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China |
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基金项目: | Heilongjiang Provincial Scientific and Technical Key Task,No. GC07C343; |
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摘 要: | Background No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI. Methods Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups: intracoronary administration of nitroprusside (group A, n=46), intracoronary administration of nitroglycerin (group B, n=46). The angJographic results were observed. The real-time myocardial contrast echocardiography (RT-MCE), including contrast score index (CSI), wall motion score index (WMSI), transmural contrast defect length (CDL) and serious WM abnormal length (WML) were recorded at 24 hours and 1 week post-PCI. High sensitivity C-reactive protein (Hs-CRP) was examined by immune rate nephelometry. N-terminal prohormone brain natriuretic peptide (NT-proBNP) was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events (MACE) were recorded. Results The incidence of final TIMI-3 flow in group A was much higher than that in Group B (P 〈0.05), final corrected TIMI frame count (cTFC) in group A decreased significantly than that in group B (P 〈0.01). The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B (P 〈0.01). Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B (P 〈0.01). Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B (P〈0.05). Conclusion Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis.
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关 键 词: | 急性心肌梗死 冠状动脉 硝普钠 预防 |
Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction |
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Authors: | PAN Wei WANG Lan-feng YU Jia-hui FAN Ying YANG Shu-sen ZHOU Li-jun LI Yue LI Wei-min |
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Institution: | Cardiology Department of the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China |
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Abstract: | Background No-reflow phenomenon during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) is a predictive factor of continuous myocardial ischemia, ventricular remodeling and cardiac dysfunction, which is closely associated with a worse prognosis. This study aimed to evaluate intracoronary nitroprusside in the prevention of the no-reflow phenomenon in AMI.Methods Ninety-two consecutive patients with AMI, who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups: intracoronary administration of nitroprusside (group A, n=46), intracoronary administration of nitroglycerin (group B, n=46). The angiographic results were observed. The real-time myocardial contrast echocardiography (RT-MCE), including contrast score index (CSI), wall motion score index (WMSI), transmural contrast defect length (CDL) and serious WM abnormal length (WML) were recorded at 24 hours and 1 week post-PCI.High sensitivity C-reactive protein (Hs-CRP) was examined by immune rate nephelometry. N-terminal prohormone brain natriu retic peptide (NT-proBNP) was tested with enzyme-linked immunosorbent assay. Patients were followed up for six months. Major adverse cardiac events (MACE) were recorded.Results The incidence of final TIMI-3 flow in group A was much higher than that in Group B (P <0.05), final corrected TIMI frame count (cTFC) in group A decreased significantly than that in group B (P <0.01). The CSI, CDL/LV length,WMSI and WL/LV length in group A were significantly lower than that in group B (P <0.01). Levels of Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B (P<0.01). Patients were followed up for 6 months and the incidence of MACE in group A was significantly lower than that in group B (P<0.05).Conclusion Intracoronary nitroprusside can improve myocardial microcirculation, leading to the decrease of the incidence of no-reflow phenomenon and better prognosis. |
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Keywords: | nitroprusside acute myocardial infarction no-reflow phenomenon prognosis |
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