Intracoronary nitroprusside in the prevention of the no-reflow phenomenon in acute myocardial infarction  

作　　者：PAN Wei WANG Lan-feng YU Jia-hui FAN Ying YANG Shu-sen ZHOU Li-jun LI Yue LI Wei-min 

机构地区：[1]Cardiology Department of the First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, China

出　　处：《Chinese Medical Journal》2009年第22期2718-2723,共6页中华医学杂志（英文版）

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 prBackground 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 pr

关 键 词：nitroprusside acute myocardial infarction no-reflow phenomenon prognosis 

分 类 号：R686[医药卫生—骨科学]