title: Intravenous versus intracoronary bolus of glycoprotein IIb/IIIa inhibitor administration during primary percutaneous coronary intervention on long-term left ventricular systolic and diastolic function.
abstract: BACKGROUND
  In primary percutaneous coronary intervention (PCI), glycoprotein (GP) IIb/IIIa inhibitors are often given in order to attain and maintain better myocardial perfusion. We tested the hypothesis that intracoronary (IC) bolus of GP IIb/IIIa inhibitors might produce a greater improvement in left ventricular (LV) systolic and diastolic function than an intravenous(IV) bolus.
  
  
  RESULTS
  Seventy seven patients undergoing primary PCI for their first ST elevation myocardial infarction (STEMI) were randomly assigned to either an IC or IV bolus of GP IIb/IIIa inhibitor, followed by IV infusion. Compared with the echocardiographic findings within 3 days after PCI, LV ejection fraction was higher at 1 year, with no significant differences between the IV and IC groups (IV: 44% vs. 49%, p = 0.001; IC: 43% vs. 48%,p < 0.001). LV diastolic function (E/E') did not significantly change at 1 year by either approach.
  
  
  CONCLUSIONS
  LV systolic function improved by a similar magnitude following primary PCI, with either IC or IV bolus administration of GP IIb/IIIa inhibitor therapy. However, no significant changes were observed in LV diastolic function.
authors.affiliation: Department of Cardiology, Hull and East Yorkshire Medical Research and Teaching Centre, MRTDS (Daisy) Building, Castle Hill Hospital, Cottingham, UK; Heart and Great Vessel Department, Policlinico Umberto I, Sapienza University, Rome, Italy. pierpaolo.pellicori@hey.nhs.uk.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Pellicori
authors.forename: Concetta
authors.initials: C
authors.lastname: Torromeo
authors.forename: Francesco
authors.initials: F
authors.lastname: Barillà
authors.forename: Enrico
authors.initials: E
authors.lastname: Mangieri
authors.forename: Antonietta
authors.initials: A
authors.lastname: Evangelista
authors.forename: Giovanni
authors.initials: G
authors.lastname: Truscelli
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Costanzo
authors.forename: Angela
authors.initials: A
authors.lastname: Hoye
authors.forename: Kenneth
authors.initials: K
authors.lastname: Wong
mesh_terms: D000077284:Abciximab; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003331:Coronary Vessels; D003971:Diastole / Q000187:drug effects; D000077542:Eptifibatide; D005260:Female; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010455:Peptides / Q000008:administration & dosage*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D020127:Recovery of Function; D012384:Rome; D013599:Systole / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010455:Peptides; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D000077542:Eptifibatide; D000077284:Abciximab