Left ventricular remodeling after primary coronary angioplasty in patients treated with abciximab or intracoronary adenosine - 21/08/11
, Marco De Carlo, MD a, Nicola Ciabatti, MD a, Giovanni Amoroso, MD, PhD a, Ugo Limbruno, MD, PhD a, Caterina Palagi, MD, PhD a, Vitantonio Di Bello, MD a, Maria F. Romano, PhD b, Mario Mariani, MD aRésumé |
Background |
Primary angioplasty is the best treatment of acute myocardial infarction but fails to achieve adequate myocardial reperfusion in 25% to 30% of patients, despite TIMI grade 3 flow. Drug treatment aimed at reducing the no-reflow phenomenon may improve myocardial salvage, thus preventing left ventricular remodeling. Our aim was to evaluate the impact of abciximab and adenosine on immediate angiographic results and on 6-month left ventricular remodeling.
Methods |
Ninety consecutive patients undergoing primary angioplasty with coronary stenting were randomized in a sequential alternating fashion to standard abciximab treatment (ABCX) group, intracoronary adenosine distal to the occlusion (ADO) group, or neither (CTRL) group. All patients underwent a clinical and echocardiographic follow-up at 1 and 6 months. The primary end point was the prevalence of 6-month left ventricular remodeling.
Results |
Baseline clinical, echocardiographic, and angiographic characteristics were similar. Mean final corrected TIMI frame count was 17 ± 9, 16 ± 12, and 23 ± 11 frames in ABCX, ADO, and CTRL patients, respectively (P = .002). Angiographic no-reflow was observed in 7%, 13%, and 17% of ABCX, ADO, and CTRL patients, respectively (P > .20). At 6 months, left ventricular remodeling occurred in 7%, 30%, and 30% of ABCX, ADO, and CTRL patients, respectively (P = .045), with a percent increase in end-diastolic volume of 5% ± 13%, 15% ± 15%, and 12% ± 18% (P = .04).
Conclusions |
During primary angioplasty, abciximab enhances myocardial reperfusion, translating into a reduced incidence of 6-month left ventricular remodeling. In contrast, adenosine administration improves angiographic results but does not prevent left ventricular remodeling.
Le texte complet de cet article est disponible en PDF.Plan
Vol 150 - N° 5
P. 1015.1-1015.e9 - novembre 2005 Retour au numéro
Article précédent
- Relationship of a comprehensive panel of plasma oxidized low-density lipoprotein markers to angiographic restenosis in patients undergoing percutaneous coronary intervention for stable angina
- Amit Segev, Bradley H. Strauss, Joseph L. Witztum, Herbert K. Lau, Sotirios Tsimikas
- Early versus periprocedural administration of abciximab for primary angioplasty: A pooled analysis of 6 studies
- Jochen Gödicke, Marcus Flather, Marko Noc, Mariann Gyöngyösi, Hans-Richard Arntz, Lars Grip, Henrique Mesquita Gabriel, Kurt Huber, Fiona Nugara, Joachim Schröder, Leif Svensson, Duolao Wang, Simona Zorman, Gilles Montalescot
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?