Attenuation of the no-reflow phenomenon after coronary angioplasty for acute myocardial infarction with intracoronary papaverine.
The no-reflow phenomenon is observed as reduction of coronary blood flow on the angiograms (angiographic no-reflow) after immediate percutaneous transluminal coronary angioplasty (PTCA) in patients with acute myocardial infarction (AMI). To assess whether a potent coronary microvascular dilator--papaverine--could attenuate the no-reflow phenomenon, nine patients with AMI who were found to have angiographic no-reflow after PTCA were studied. Angiographic no-reflow was defined as the Thrombolysis in Myocardial Infarction flow grade 1 or 2 without any mechanical obstructions in the epicardial artery. A bolus dose of 10 mg of intracoronary papaverine was administered, and the flow grade was again evaluated. Intracoronary papaverine caused a significant improvement of the flow grade (p= 0.0152). The number of cineframes that were required for the contrast medium to pass two selected landmarks on the angiograms also significantly decreased (41 +/- 17 frames to 18 +/- 8 frames, p= 0.0039). Thus intracoronary papaverine attenuated angiographic no-reflow that occurred after PTCA for AMI.
Department of Cardiology, Hiroshima City Hospital, Japan.
M
M
Ishihara
H
H
Sato
H
H
Tateishi
T
T
Kawagoe
Y
Y
Shimatani
S
S
Kurisu
K
K
Sakai
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D005260:Female; D006321:Heart / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D010208:Papaverine / Q000494:pharmacology*; D012039:Regional Blood Flow; D014665:Vasodilator Agents / Q000494:pharmacology*
D014665:Vasodilator Agents; D010208:Papaverine