Effects of verapamil and adenosine in an adjunct to tirofiban on resolution and prognosis of noreflow phenomenon in patients with acute myocardial infarction.

Abstract

AIM:

We aimed to investigate the effects of verapamil and adenosine in an adjunct to intravenous tirofiban on management and prognosis of no-reflow phenomenon during primary percutaneous coronary intervention (PPCI) and to compare their efficacies on reversing of no-reflow phenomenon and short and midterm survival.

METHODS:

We included 46 patients with acute ST-segment elevation myocardial infarction (STEMI) and occurrence of no-reflow phenomenon after PPCI. All patients received intravenous tirofiban and then randomized into one of the following 3 groups: intracoronary adenosine (N.=16), intracoronary verapamil (N.=15) or placebo (N.=15).

RESULTS:

Intracoronary verapamil therapy had significant effect in restoring impaired coronary blood flow by decreasing thrombolysis in myocardial infarction (TIMI) frame count from 73±44 to 52±48 (P=0.024). However, adenosine and serum physiologic administration were not found to be so effective in decreasing TIMI frame count (from 81±35 to 71±46, P=0.084; from 74±32 to 71±37, P=0.612, respectively). In-hospital and 6-month survival rates were similar among groups.

CONCLUSION:

In conclusion, intracoronary verapamil restored the impaired coronary blood flow more effectively than adenosine or placebo. However, none of them has changed the clinical course in the first 6 months.

• Authors: I Faruk Akturk, A Arif Yalcin, I Biyik, C Sarikamis, N Turhan Caglar, M Erturk, O Celik, F Uzun, I Murat Caglar, E Oner
• Journal: Minerva cardioangiologica (Minerva Cardioangiol) Vol. 62 Issue 5 Pg. 389-97 (Oct 2014) ISSN: 1827-1618 [Electronic] Italy
• PMID: 24699550 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Fibrinolytic Agents
• Vasodilator Agents
• Tyrosine
• Verapamil
• Tirofiban
• Adenosine

Topics

• Adenosine (administration & dosage, therapeutic use)
• Aged
• Female
• Fibrinolytic Agents (administration & dosage, therapeutic use)
• Follow-Up Studies
• Hospital Mortality
• Humans
• Male
• Middle Aged
• Myocardial Infarction (physiopathology, therapy)
• No-Reflow Phenomenon (drug therapy, etiology)
• Percutaneous Coronary Intervention (methods)
• Prognosis
• Prospective Studies
• Survival Rate
• Tirofiban
• Tyrosine (administration & dosage, analogs & derivatives, therapeutic use)
• Vasodilator Agents (administration & dosage, therapeutic use)
• Verapamil (administration & dosage, therapeutic use)