Document Detail


Left ventricular remodeling after primary coronary angioplasty in patients treated with abciximab or intracoronary adenosine.
MedLine Citation:
PMID:  16290987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Primary angioplasty is the best treatment of acute myocardial infarction but fails to achieve adequate myocardial reperfusion in 25% to 30% of patients, despite TIMI grade 3 flow. Drug treatment aimed at reducing the no-reflow phenomenon may improve myocardial salvage, thus preventing left ventricular remodeling. Our aim was to evaluate the impact of abciximab and adenosine on immediate angiographic results and on 6-month left ventricular remodeling. METHODS: Ninety consecutive patients undergoing primary angioplasty with coronary stenting were randomized in a sequential alternating fashion to standard abciximab treatment (ABCX) group, intracoronary adenosine distal to the occlusion (ADO) group, or neither (CTRL) group. All patients underwent a clinical and echocardiographic follow-up at 1 and 6 months. The primary end point was the prevalence of 6-month left ventricular remodeling. RESULTS: Baseline clinical, echocardiographic, and angiographic characteristics were similar. Mean final corrected TIMI frame count was 17 +/- 9, 16 +/- 12, and 23 +/- 11 frames in ABCX, ADO, and CTRL patients, respectively (P = .002). Angiographic no-reflow was observed in 7%, 13%, and 17% of ABCX, ADO, and CTRL patients, respectively (P > .20). At 6 months, left ventricular remodeling occurred in 7%, 30%, and 30% of ABCX, ADO, and CTRL patients, respectively (P = .045), with a percent increase in end-diastolic volume of 5% +/- 13%, 15% +/- 15%, and 12% +/- 18% (P = .04). CONCLUSIONS: During primary angioplasty, abciximab enhances myocardial reperfusion, translating into a reduced incidence of 6-month left ventricular remodeling. In contrast, adenosine administration improves angiographic results but does not prevent left ventricular remodeling.
Authors:
Anna S Petronio; Marco De Carlo; Nicola Ciabatti; Giovanni Amoroso; Ugo Limbruno; Caterina Palagi; Vitantonio Di Bello; Maria F Romano; Mario Mariani
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  150     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-18     Completed Date:  2005-12-29     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1015     Citation Subset:  AIM; IM    
Affiliation:
CardioThoracic Department, University of Pisa, Pisa, Italy. a.petronio@ao-pisa.toscana.it
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MeSH Terms
Descriptor/Qualifier:
Adenosine / administration & dosage*
Angioplasty, Transluminal, Percutaneous Coronary*
Antibodies, Monoclonal / therapeutic use*
Coronary Vessels
Female
Humans
Immunoglobulin Fab Fragments / therapeutic use*
Male
Middle Aged
Ventricular Remodeling*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 143653-53-6/abciximab; 58-61-7/Adenosine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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