scholarly journals COMPARISON OF INTRACORONARY VERAPAMIL VS ADENOSINE FOR RESTORATION OF CORONARY BLOOD FLOW POST PERCUTANEOUS CORONARY INTERVENTION (PCI) IN PATIENTS WITH NO-REFLOW

2021 ◽  
Vol 70 (Suppl-4) ◽  
pp. S833-37
Author(s):  
Mohsin Saif ◽  
Obaid -Ur- Rahman ◽  
Muhammad Umar Amin ◽  
Hamid Sharif Khan ◽  
Ghulam Rasool Maken ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Coronary Blood Flow ◽  
Coronary Intervention ◽  
Double Blind ◽  
No Reflow ◽  
Intracoronary Administration ◽  
Heparinized Saline ◽  
Grade 3 ◽  
Group B

Objective: To determine the efficacy of intracoronary verapamil vs adenosine in restoration of coronary blood flow, post PCI in patients with No-Reflow. Study Design: Double blind (patient/operator blind) randomized control trial. Place and Duration of Study: Cath lab of AFIC & NIHD Rawalpindi, from Feb 2019 to Aug 2019. Methodology: A total of ninety (n=90) patients of either gender between age 25-80 years of age who underwent angioplasty for STEMI/NSTEMI demonstrating No-Reflow (thrombolysis in myocardial infarction 0,1,2) post PCI were enrolled and were randomized into two groups. Group A received verapamil 500 µg in 10 ml heparinized saline, given slowly over 1 minute and group B received adenosine 60 µg in 10 ml of heparinized saline, given quickly. After the administration of both drugs repeat angiogram was carried out and thrombolysis in Myocardial Infarction flow was assessed. Restoration of blood flow was defined as achievement of thrombolysis in myocardial infarction 3 grade. Results: Efficacy (restoration of thrombolysis in Myocardial Infarction grade 3) was better with intracoronary administration of verapamil when compared with intracoronary administration 2 of adenosine (84.4% vs 80%). The difference was, however, not statistically significant (p=0.581). Conclusion: Efficacy (restoration of thrombolysis in myocardial infarction grade 3) was not statistically significant between intracoronary administration of verapamil and adenosine in no-reflow cases after PCI in patients with STEMI/NSTEMI.

Effect of routine postdilatation on final coronary blood flow in primary percutaneous coronary intervention patients without angiographic stent expansion problems

2018 ◽  
Vol 66 (8) ◽  
pp. 1096-1101
Author(s):  
Korhan Soylu ◽  
Ali Ekber Ataş ◽  
Mustafa Yenerçağ ◽  
Murat Akçay ◽  
Onur Şeker ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Percutaneous Coronary Intervention ◽  
Coronary Blood Flow ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Timi Flow ◽  
Stent Expansion ◽  
Increased Risk ◽  
Percutaneous Coronary

Inadequate expansion of coronary stents is associated with stent thrombosis in early stage and with stent restenosis in later stages. Postdilatation (postD) performed using non-compliant balloons improves stent expansion. However, use of this ballooning strategy in primary percutaneous coronary intervention (PPCI) has not been evaluated adequately. Patients who presented with ST segment elevation myocardial infarction (STEMI) and underwent PPCI were included in the present study. Patients were randomized into two groups as those for whom postD was performed (n=62) and those for whom postD was not performed (n=62). Coronary blood flow was evaluated using the thrombolysis in myocardial infarction (TIMI) flow and TIMI frame count (TFC). Total of 124 patients with STEMI were included in the study. There was no difference with respect to baseline TIMI flow, culprit coronary artery and MI localization. However, slow-reflow rate (14.5% vs 35.5%, p=0.007) and final corrected TFC (28.9±16.9 vs 37.0±23.1, p=0.028) were significantly higher in the postD group. Multivariate regression analysis showed postD as an independent variable for slow reflow (OR 11.566, 95% CI 1.633 to 81.908, p=0.014). In our study, routine postD during PPCI was found to be associated with an increased risk of slow reflow in patients without angiographic stent expansion problems.

scholarly journals Efficacy of intravenous eptifibatide in primary percutaneous coronary intervention patients

2021 ◽  
Vol 14 (3) ◽  
pp. 376-382
Author(s):  
Rozita Jalalian ◽  
◽  
◽  
Samad Golshani ◽  
Hossein Farsavian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Flow ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Angioplasty ◽  
Primary Pci ◽  
Heparin Group ◽  
Double Blind ◽  
Percutaneous Coronary

Early and complete restoration of blood flow in closed coronary arteries is the main goal in treating patients with myocardial infarction. Primary angioplasty is not always successful in establishing myocardial blood flow. Although the strategy of adding eptifibatide leads to better blood flow, its value as part of a routine strategy is questionable. Therefore, this study was performed to evaluate the efficacy of intravenous eptifibatide in primary percutaneous coronary intervention (PCI) patients. This clinical, randomized, double-blind trial was performed on patients aged 20-80 years undergoing primary PCI. The patients were selected for study by convenience sampling and were randomly divided into two equal groups. The first group was treated with intravenous eptifibatide immediately before angioplasty with heparin. The second group received only coronary angioplasty with heparin. After data collection, statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, version 16. A total of 104 patients were enrolled in the study, and there were no statistically significant differences in terms of age (P=0.188), gender (P=0.345), risk factor (P>0.05), or history of PCI (P=0.199). Mean thrombolysis in myocardial infarction (TIMI) score was not significant between the two groups after receiving the drug and performing angioplasty (P>0.05), and the rate of ejection fraction was 46.33±6.69 in patients receiving eptifibatide and 47.54±4.67 in the heparin group, which was not statistically significant (P=0.884). We found that eptifibatide improves clinical indexes in patients undergoing primary PCI, but these differences were not significant in the two groups.

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