Intracoronary Administration of a Thromboxane A_2 Synthase Inhibitor Relieves Acetyicholine-Induced Coronary Spasm

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概要

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• This study sought to clarify the effectiveness of intracoronary administration of a thromboxane (TX) A_2 synthase inhibitor, Ozagrel Na, to relieve coronary spasms induced by intracoronary injection of acetyicholine (ACh). An ACh spasm provocation test was performed in 92 consecutive patients with coronary spastic angina using incremental doses of 20, 50, and 80★g into the right coronary artery, and 20, 50, and 100★g into the left coronary artery within 20s. A coronary spasm was defined as TIMI 0 or 1 flow and an intracoronary injection of 20mg Ozagrel Na was administered when it was provoked. Within 2 min of the administration of the TXA_2 synthase inhibitor, ACh-induced coronary spasms were relieved (TIMI 3 flow) in 88.1% of procedures without complications. In only 4 cases (4.3%), it took more than 3 min to relieve the coronary spasms. Intracoronary administration of 20mg Ozagrel Na when ACh-induced spasms occurred, shortened the spasm relief time in all 7 patients (200★59 s vs 111★23s, p<0.01), improved the maximal ST segment elevation in 5 of them (3.9★3.7mm vs 0.7★1.5 mm, p<0.05), and stopped chest pain in 4 patients. In 4 patients who had ACh-induced coronary spasm of the left anterior descending artery, the TXB_2 concentration in the coronary sinus decreased after intracoronary administration of Ozagrel Na into the left coronary artery (463★562 vs 96★45, p<0.01). In conclusion, intracoronary administration of a TXA_2 synthase inhibitor can relieve ACh-induced coronary spasms by inhibiting TXA_2 synthesisin the local coronary circulation.

• 社団法人日本循環器学会の論文
• 2002-08-20

著者

• SUZUKI Jun

  Department of Health Care Chemistry, College of Environmental Health, Azabu University

• INOUE Katsuji

  Department of Integrated Medicine and Informatics, Ehime University Graduate School of Medicine

• Watanabe Kouki

  Uwashima City Hospital

• Watanabe Kouki

  Department Of Biofunctional Science Faculty Of Agriculture And Life Science Hirosaki University

• SUEDA Shozo

  Department of Internal Medicine, Ehime Prefectural Niihama Hospital

• Watanabe Koki

  Uwashima City Hospital

• Kohno Hiroaki

  Department of Cardiology, Saiseikai Saijo Hospital

• Fukuda Hiroshi

  Department of Cardiology, Saiseikai Saijo Hospital

• Ochi Naoto

  Department of Cardiology, Kita Medical Association Hospital

• Kawada Hiroyuki

  Department of Cardiology, Kita Medical Association Hospital

• Uraoka Tadao

  Department of Cardiology, Kita Medical Association Hospital

• Sueda Shozo

  Department Of Cardiology Saiseikai Saijo Hospital

• Sueda Shozo

  Department Of Cardiology Ehime Prefectural Niihama Hospital

• Suzuki Jun

  Department Of Cardiovascular Medicine Tohoku University Graduate School Of Medicine

• Ochi Naoto

  Department Of Cardiology Kita Medical Association Hospital

• Uraoka Tadao

  Department Of Cardiology Kita Medical Association Hospital

• Inoue Katsuji

  Department Of Cardiology Saiseikai Saijo Hospital

• Kawada Hiroyuki

  Department Of Cardiology Ehime Prefectural Imabari Hospital

• Watanabe Koki

  Saiseikai Matsuyama Hospital

• Fukuda Hiroshi

  Department Of Anatomy Kobe University School Of Medicine

• Kohno Hiroaki

  Department Of Cardiology Ehime Prefectural Niihama Hospital

• Watanabe Kouki

  Department Of Cardiology Uwajima City Hospital

• Kawada Hiroyuki

  Department Of Cardiology Kita Medical Association Hospital

• Suzuki Jun

  Department Of Cardiology Saiseikai Saijo Hospital

• KAWADA Hiroyuki

  Department of Applied Mechanics and Aerospace Engineering, Waseda University

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