| Distal myocardial protection during percutaneous coronary intervention with an intracoronary beta-blocker. | |
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MedLine Citation:
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PMID: 12771007 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Experimental studies have demonstrated that intravenous beta-blocker administration before coronary artery occlusion significantly reduces myocardial injury. Clinical studies have shown that intracoronary (IC) propranolol administration before percutaneous coronary intervention (PCI) delays myocardial ischemia. The present study tested the hypothesis that IC propranolol treatment protects ischemic myocardium from myocardial damage and reduces the incidence of myocardial infarction (MI) and short-term adverse outcomes after PCI. METHODS AND RESULTS: Patients undergoing PCI (n=150) were randomly assigned in a double-blind fashion to receive IC propranolol (n=75) or placebo (n=75). Study drug was delivered before first balloon inflation via an intracoronary catheter with the tip distal to the coronary lesion. Biochemical markers were evaluated through the first 24 hours and clinical outcomes to 30 days. Evidence of MI with creatine kinase-MB elevation after PCI was seen in 36% of placebo and 17% of propranolol patients (P=0.01). Troponin T elevation was seen in 33% of placebo and 13% of propranolol patients (P=0.005). At 30 days, the composite end point of death, postprocedural MI, non-Q-wave MI after PCI hospitalization, or urgent target-lesion revascularization occurred in 40% of placebo versus 18% of propranolol patients (hazard ratio 2.14, 95% CI 1.24 to 3.71, P=0.004). CONCLUSIONS: IC administration of propranolol protects the myocardium during PCI, significantly reducing the incidence of MI and improving short-term clinical outcomes. |
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Authors:
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Fen Wei Wang; Abdulfatah Osman; Javier Otero; George A Stouffer; Sergio Waxman; Adnan Afzal; Angelo Anzuini; Barry F Uretsky |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial Date: 2003-05-27 |
Journal Detail:
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Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Jun |
Date Detail:
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Created Date: 2003-06-19 Completed Date: 2003-07-01 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 2914-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Division of Cardiology, The University of Texas Medical Branch at Galveston, 301 University Blvd, 5.106 JSHA, Galveston, Tex 77555-0553, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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administration & dosage* Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects Aspirin / administration & dosage Biological Markers / analysis Coronary Artery Disease / therapy* Creatine Kinase / analysis Creatine Kinase, MB Form Double-Blind Method Female Heart / drug effects Humans Injections, Intra-Arterial Isoenzymes / analysis Male Middle Aged Multivariate Analysis Myocardial Infarction / etiology, prevention & control* Platelet Aggregation Inhibitors / administration & dosage Propranolol / administration & dosage* Risk Sample Size Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Biological Markers; 0/Isoenzymes; 0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin; 525-66-6/Propranolol; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form |
| Comments/Corrections | |
Comment In:
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Circulation. 2003 Jun 17;107(23):e9050-1
[PMID:
12814988
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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