| Left ventricular remodeling after primary coronary angioplasty in patients treated with abciximab or intracoronary adenosine. | |
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MedLine Citation:
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PMID: 16290987 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: American heart journal Volume: 150 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2005 Nov |
Date Detail:
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Created Date: 2005-11-18 Completed Date: 2005-12-29 Revised Date: 2006-02-27 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 1015 Citation Subset: AIM; IM |
Affiliation:
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CardioThoracic Department, University of Pisa, Pisa, Italy. a.petronio@ao-pisa.toscana.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adenosine
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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:
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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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