Selective Intracoronary Administration of Nitroprusside Before Balloon Dilatation Prevents Slow Reflow During Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction
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概要
- 論文の詳細を見る
Background: Previous studies have shown that intracoronary nitroprusside injection is safe and effective after slow reflow complicates percutaneous coronary intervention (PCI). Objectives: We sought to determine the safety and efficacy of selective intracoronary administration of nitroprusside through the drug delivery catheter before balloon dilatation to prevent no or slow reflow during PCI for acute myocardial infarction (AMI). Methods: We studied 120 consecutive patients with AMI treated by PCI. In 60 patients (nitroprusside group), nitroprusside (120 μg) was selectively administered through the drug delivery catheter into the distal coronary artery to reach the target lesion before balloon dilatation. Clinical and angiographic data, as well as in-hospital outcomes, of the nitroprusside group were retrospectively compared with 60 patients who had conventional PCI without nitroprusside (control group). Results: There were no significant differences in the baseline clinical and angiographic characteristics between the 2 groups. Compared to the control group, the nitroprusside group had 1) less slow reflow during the procedure (12% versus 35%, P = 0.0025), 2) a shorter fluoroscopic time (14.4 ± 7.9 versus 18.7 ± 9.1 minutes, P = 0.0093), 3) a shorter procedure time (57.6 ± 20.6 versus 78.1 ± 26.4, P < minutes, P < 0.0001), 4) a better final TIMI flow grade (III:II:I:0 = 59:1:0:0 versus 53:6:1:0, P = 0.0284), 5) a better blush grade (III:II:I:0 = 49:10:1:0 versus 33:15:8:4, P = 0.0006), and 6) a better corrected TIMI coronary flame count (30.8 ± 13.7 versus 46.5 ± 44.7, P = 0.0102). There were no particular complications with nitroprusside use. Conclusions: The selective intracoronary administration of nitroprusside prior to PCI is safe and well tolerated, prevents no or slow reflows, and improves reperfusion of the infarcted myocardium.
- インターナショナル・ハート・ジャーナル刊行会の論文
著者
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Shinozaki Norihiko
Department of Cardiology, Kokura Memorial Hospital
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Shinozaki Norihiko
長野県厚生農業協同組合連合会篠ノ井総合病院 循環器科
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Ichinose Hiroyuki
Department of Cardiology, Naganoken Koseiren Shinonoi General Hospital
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Yahikozawa Kumiko
Department of Cardiology, Naganoken Koseiren Shinonoi General Hospital
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Shimada Hirohide
Department of Cardiology, Naganoken Koseiren Shinonoi General Hospital
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Hoshino Kazuo
Department of Cardiology, Naganoken Koseiren Shinonoi General Hospital
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Yahikozawa Kumiko
Department Of Cardiolody Nagano Koseiren Shinonoi General Hospital
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Hoshino Kazuo
Department Of Cardiac Surgery And Cardiology Cardiovascular Center Shinonoi General Hospital
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Shinozaki Norihiko
Department Of Cardiac Surgery And Cardiology Cardiovascular Center Shinonoi General Hospital
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Ichinose Hiroyuki
Department Of Cardiac Surgery And Cardiology Cardiovascular Center Shinonoi General Hospital
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Shimada Hirohide
Department Of Cardiac Surgery And Cardiology Cardiovascular Center Shinonoi General Hospital
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Shinozaki Norihiko
Department of Cardiology, Naganoken Koseiren Shinonoi General Hospital
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