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Verapamil Reverses Myocardial No-Reflow After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction

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Abstract

The present study evaluated the efficacy of intracoronary administration of verapamil to attenuate the no-reflow phenomenon following the primary percutaneous coronary intervention (PCI) in patients with the ST-segment elevation acute myocardial infarction (STEMI). A total of 201 patients with STEMI who underwent primary PCI within 12 h from the beginning of the heart attack were included. The no-reflow phenomenon was defined as substantial coronary anterograde flow of TIMI ≤2. Verapamil (100–200 μg) was injected into coronary artery immediately after no-reflow; the coronary arteriography was repeated later. Hundred and ninety-eight patients with STEMI successfully underwent primary PCI, and 246 stents were implanted with the average of 1.2 stents per patient. No-reflow occurred in 25 out of 198 patients (12.6 %). Twenty-one (84 %) patients developed the flow of TIMI ≥3 after intracoronary administration of verapamil, as revealed by repeated coronary angiography. Two patients developed transient hypotension which normalized without treatment within 3–5 min. Three patients showed sinus bradycardia, in one patient there was transient II sinoatrial block, and one patient developed type 1 atrioventricular block. All adverse effects were alleviated after intravenous injection of atropine (0.5–1 mg). In conclusion, the no-reflow phenomenon following primary PCI in patients with STEMI is significantly improved by intracoronary administration of verapamil which is useful to reduce cardiovascular events during operation.

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Authors and Affiliations

  1. Department of Cardiology, Xuzhou Cardiovascular Diseases Institute, Xuzhou Hospital Affiliated East South University School of Medicine, No. 199 Jiefang Road, Xuzhou, 221009, China

    Qiang Fu, Wen Lu, Yi-jie Huang, Qiang Wu, Lin-guang Wang, Hai-bo Wang, Shu-zhong Jiang & Yan-jiong Wang

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  1. Qiang Fu
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  2. Wen Lu
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  3. Yi-jie Huang
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  4. Qiang Wu
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  5. Lin-guang Wang
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  6. Hai-bo Wang
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  7. Shu-zhong Jiang
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  8. Yan-jiong Wang
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Correspondence to Qiang Fu.

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Fu, Q., Lu, W., Huang, Yj. et al. Verapamil Reverses Myocardial No-Reflow After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction. Cell Biochem Biophys 67, 911–914 (2013). https://doi.org/10.1007/s12013-013-9581-0

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