Abstract
Objective To evaluate the efficacy and safety of different drugs injected via balloon catheter for no-reflow after percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI). Methods From January 2016 to December 2017, 1 280 patients with STEMI were treated in Department of Cardiology, Beijing Luhe Hospital. All patients were underwent PCI and stent implantation in related infarct vessels (IRA). Among 1 280 patients no-reflow occurred in 164 cases (12.81%) during the procedure. No-reflow patients were divided into three study groups according to the order of consultation, who were given verapamil (verapamil group,55 cases),tirofiban (tirofiban group, 55 cases) or nitroglycerin (nitroglycerin group, 54 cases) by injection through balloon catheter. Coronary blood flow recovery (TIMI grading),myocardial perfusion level TMP grading (TMPG),average dose of drugs (mg) and adverse drug reactions (ADR) were compared among the three groups. Left ventricular ejection fraction (LVEF) and left ventricular end diastolic volume (LVEDV) were evaluated by echocardiography 7 and 30 d after operation. The incidence of major adverse cardiovascular events (MACE) was followed up. Results TIMI-3 ratio in verapamil, tirofiban and nitroglycerin groups was 89.90% (49/55), 91.82% (45/55) and 61.11% (33/54), respectively (Hc=13.920, P 0.05). There was no significant difference in LVEF and LVEDV among three groups on the d7 after operation (all P>0.05). The improvement of LVEF and LVEDV was more significant in verapamil group on d30 after operation (all P 0.05). Conclusion Verapamil can be injected throμgh balloon catheter to restore coronary blood flow rapidly, effectively and safely,and improve left ventricular function in STEMI patients with no-reflux during PCI. Key words: Myocardial infarction; No-reflow phenomenon; Percutaneous coronary intervention; Vera pammy
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