title: Intracoronary followed by intravenous administration of the short-acting β-blocker landiolol prevents myocardial injury in the face of elective percutaneous coronary intervention.
abstract: BACKGROUND
  Myocardial injury during elective percutaneous coronary intervention (PCI) is associated with higher subsequent cardiac events and mortality. β-Blockers have been used to reduce myocardial injury during ischemia and reperfusion. We investigated whether intracoronary followed by intravenous administration of the short-acting β-blocker landiolol prevents myocardial injury in the face of elective PCI.
  
  
  RESULTS
  Patients undergoing elective PCI (n=70) were randomly assigned to the landiolol (n=35) or control (n=35) group. Landiolol or saline was administered into target vessels through a balloon catheter for 1min before and after first balloon inflation followed by continuous intravenous administration for 6h after PCI. The incidence of myocardial injury defined by cardiac troponin-I (cTnI) >/=0.05 ng/ml was 79% of the patients in the control group compared to 56% in the landiolol group (p=0.04). The cTnI level at 24h after PCI tended to be lower in the landiolol group (0.57 ± 1.14 versus 1.27 ± 2.48 ng/ml; p=0.07), while the CK-MB level was not significantly different between the landiolol and control groups. The incidence of peri-procedural myocardial infarction defined by cTnI >/=0.12 ng/ml was significantly (p=0.02) lower in the landiolol group (41%) compared to the control group (70%). There was no incidence of coronary spasm, hypotension, bradycardia or heart failure during and after PCI in the two groups.
  
  
  CONCLUSIONS
  Brief intracoronary followed by continuous intravenous administration of landiolol is safe and effective for myocardial protection in the face of elective PCI.
authors.affiliation: Second Department of Internal Medicine, Kansai Medical University, Moriguchi City, Japan.
authors.forename: Haengnam
authors.initials: H
authors.lastname: Park
authors.forename: Hajime
authors.initials: H
authors.lastname: Otani
authors.forename: Teppei
authors.initials: T
authors.lastname: Noda
authors.forename: Daisuke
authors.initials: D
authors.lastname: Sato
authors.forename: Toru
authors.initials: T
authors.lastname: Okazaki
authors.forename: Takanao
authors.initials: T
authors.lastname: Ueyama
authors.forename: Junji
authors.initials: J
authors.lastname: Iwasaka
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Toshiji
authors.initials: T
authors.lastname: Iwasaka
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000368:Aged; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D013997:Time Factors; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000319:Adrenergic beta-Antagonists; D009025:Morpholines; C077049:landiolol; D014508:Urea