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Effect of Chronic Pretreatment of Angiotensin-Converting Receptor Blocker on No-Reflow Phenomenon in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.
MedLine Citation:
PMID:  22953997     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims: Angiotensin receptor blockers (ARBs) exert favorable effects on the vascular system, which are not directly related to hypertension lowering function. The no-reflow phenomenon determines the prognosis in patients after acute myocardial infarction (AMI). Early ARB treatment has many beneficial effects on the prognosis after AMI. In the present study, we tested the hypothesis that ARB treatment before admission would have beneficial effects on the development of the no-reflow phenomenon after infarction. Methods: We investigated 276 consecutive patients with AMI undergoing successful primary percutaneous coronary intervention (PCI). No-reflow was defined as Thrombolysis in Myocardial Infarction (TIMI) flow grade <3, which was determined by the TIMI frame count method using angiographic images obtained just after PCI and stenting. Results: Compared with patients without ARB treatment, patients with ARB had more frequently hypertension and ST resolution (P<0.05 respectively), but no significant difference was found in the other clinical characteristics (age, sex, Hyperlipidaemia, Diabetes mellitus, etc) between the two groups. A total of 51 patients receiving chronic ARB treatment before admission have lower incidence of the no-reflow phenomenon than those without chronic ARB treatment (8.7% and 26.7%, P = 0.003). However, the incidence of the no-reflow phenomenon between the patients with and without hypertension had no significant difference. Multivariable logistic regression analysis revealed that ARB pretreatment was a significant predictor of the no-reflow phenomenon, whereas blood pressure was found to be insignificant. Conclusion: Chronic pre-treatment of ARB is associated with the reduction of the no-reflow phenomenon in patients with reperfused AMI and could preserve microvascular integrity after AMI independent of blood pressure lowering, which may contribute to better functional recovery.
Authors:
Tao Hu; Hai-Chang Wang; Ru-Tao Wang; An-Lin Lv; Rong-Hua Luan; Cheng-Xiang Li; He-Xiang Cheng; Cheng-Hai Xia; Ling Tao
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-10
Journal Detail:
Title:  Cardiovascular therapeutics     Volume:  -     ISSN:  1755-5922     ISO Abbreviation:  Cardiovasc Ther     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-9-7     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101319630     Medline TA:  Cardiovasc Ther     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 Blackwell Publishing Ltd.
Affiliation:
Department of Cardiology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, China.
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