title: Acute effect of sodium nitroprusside on microvascular dysfunction in patients who underwent percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
abstract: Even in the era of thrombus aspiration and distal protection for ST-segment elevation acute myocardial infarction (STEMI), microvascular dysfunction does exist and improvement of microvascular dysfunction can improve the prognosis and/or left ventricular dysfunction. We evaluated the acute effects of nitroprusside (NTP) on coronary microvascular injury that occurred after primary percutaneous coronary intervention (PCI) for STEMI in 18 patients. The final Thrombolysis in Myocardial Infarction trial (TIMI) flow grade after PCI was 3 in 17 patients and 2 in 1 patient. The index of microcirculatory resistance (IMR) was improved significantly from 76 ± 42 to 45 ± 37 (P = 0.0006) by intracoronary NTP administration. IMR improved to the normal range (IMR < 30) in 9 patients (50%). Higher TIMI flow grade and lower IMR at baseline were observed more frequently in patients whose IMR recovered to normal range after NTP administration. NTP improved the microcirculatory dysfunction at the acute phase in patients who underwent PCI for STEMI and had final TIMI 3 flow in almost all cases.
authors.affiliation: Division of Cardiology, Asahi Rosai Hospital, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Morimoto
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ito
authors.forename: Kosuke
authors.initials: K
authors.lastname: Nakasuka
authors.forename: Satoru
authors.initials: S
authors.lastname: Sekimoto
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Miyata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inomata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yoshida
authors.forename: Nozomu
authors.initials: N
authors.lastname: Tamai
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Saeki
authors.forename: Shin
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
authors.forename: Akihiro
authors.initials: A
authors.lastname: Morino
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shimizu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008833:Microcirculation / Q000187:drug effects*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D009599:Nitroprusside / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention; D057234:Preoperative Period; D012189:Retrospective Studies; D014665:Vasodilator Agents / Q000008:administration & dosage
chemical_list: D014665:Vasodilator Agents; D009599:Nitroprusside