title: Efficacy of intracoronary nicardipine in the treatment of no-reflow during percutaneous coronary intervention.
abstract: OBJECTIVE
  The goal of this study was to evaluate the safety and efficacy of nicardipine in reversing no-reflow during percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  No-reflow is a common complication of PCI in patients with acute coronary syndromes or venous bypass graft disease. Although nicardipine has an attractive pharmacological profile and has been used clinically to treat no-reflow, there is a paucity of published data regarding its effectiveness in this setting.
  
  
  METHODS
  We conducted a retrospective analysis of 72 consecutive patients who received intracoronary nicardipine to reverse no-reflow during coronary intervention. Qualitative TIMI flow grade and quantitative TIMI frame count methods were used to assess the efficacy of nicardipine.
  
  
  RESULTS
  A mean of 460 +/- 360 mcg of intracoronary nicardipine was used. No-reflow was successfully reversed with complete restoration of TIMI 3 flow in 71 of 72 patients (98.6%). TIMI flow grade improved from 1.65 +/- 0.53 prior to nicardipine to 2.97 +/- 0.24 after treatment (P < 0.001). TIMI frame count decreased from 57 +/- 40 at the time of no-reflow to 15 +/- 12 after nicardipine administration (P < 0.001). Nicardipine therapy was well tolerated without adverse hemodynamic or chronotropic effects.
  
  
  CONCLUSIONS
  In this largest series to date, intracoronary nicardipine was demonstrated to be a safe and highly effective pharmacological agent to reverse no-reflow during PCI.
authors.affiliation: Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
authors.forename: Raymond I
authors.initials: RI
authors.lastname: Huang
authors.forename: Parul
authors.initials: P
authors.lastname: Patel
authors.forename: Paul
authors.initials: P
authors.lastname: Walinsky
authors.forename: David L
authors.initials: DL
authors.lastname: Fischman
authors.forename: J David
authors.initials: JD
authors.lastname: Ogilby
authors.forename: Mark
authors.initials: M
authors.lastname: Awar
authors.forename: Craig
authors.initials: C
authors.lastname: Frankil
authors.forename: Michael P
authors.initials: MP
authors.lastname: Savage
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D012107:Research Design; D012189:Retrospective Studies; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D009529:Nicardipine