[Effects of intracoronary diltiazem on no-reflow phenomenon after emergent percutaneous coronary intervention in patients with acute myocardial infarction].
OBJECTIVE
To assess the effects of intracoronary diltiazem on no-reflow phenomenon of infarct-related artery (IRA) after emergent percutaneous transluminal coronary angioplasty or/and intracoronary stenting (PTCA/Stenting) in the patients with acute myocardial infarction (AMI).


METHODS
We studied 34 AMI patients with no-reflow phenomenon of IRA after emergent PTCA/Stenting between January 1999 and August 2005. Urokinase-treated group (n=16) was given intracoronary urokinase 30,0000 - 50,0000 units within 15 - 30 minutes between January 1999 and April 2002 while diltiazem-treated group (n=18) was given intracoronary diltiazem 0.5 - 2 mg within 10 - 30 minutes between May 2002 and August 2005. Fifteen minutes later, coronary arteriography (CAG) was performed and the thrombolysis in myocardial infarction (TIMI) flow grade was measured.


RESULTS
No apparent change of TIMI flow grade was found between pre-administration and post-administration of intracoronary urokinase, but TIMI flow grade was significantly improved after intracoronary diltiazem (P<0.01). TIMI flow grade of diltiazem-treated group was significantly higher than that of urokinase-treated group after the administration (P<0.05). The percentage of the patients who reached TIMI flow grade 3 after the intracoronary administration was higher in the diltiazem-treated group than that in the urokinase-treated group (P<0.01).


CONCLUSIONS
The intracoronary administration of diltiazem 0.5~2mg can effectively improve the no-reflow phenomenon after emergent PTCA/Stenting in patients with AMI.
Zheng
Zhao-fen
ZF
Department of Cardiology, Xiangya Hospital, Central South University, Changsha 410008, China.
Pu
Xiao-qun
XQ
Yang
Tian-lun
TL
Li
Chuan-chang
CC
Peng
Dao-di
DD
Yu
Zai-xin
ZX
Mo
Long
L
Chen
Xiao-bin
XB
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004110:Diltiazem / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D054318:No-Reflow Phenomenon / Q000188:drug therapy*; D015607:Stents; D016896:Treatment Outcome
D004110:Diltiazem