Document Detail


Pretreatment with intragraft verapamil prior to percutaneous coronary intervention of saphenous vein graft lesions: results of the randomized, controlled vasodilator prevention on no-reflow (VAPOR) trial.
MedLine Citation:
PMID:  12042618     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intragraft verapamil is effective in treating no-reflow during saphenous vein graft (SVG) percutaneous coronary intervention (PCI). In this study, we assessed the use of intragraft verapamil given pre-PCI to prevent no-reflow. METHODS: Patients undergoing SVG PCI were randomized to receive intragraft 200 g verapamil or no verapamil immediately prior to PCI. Pre- and post-PCI, vessel flow was assessed using TIMI flow grade and TIMI frame count by blinded angiographic readers. Tissue level perfusion in the graft territory was assessed using the TIMI myocardial perfusion grade (TMPG). CK-MB or troponin I levels were measured 6 12 hours post-PCI. RESULTS: Ten patients were randomized to the verapamil group and 12 were assigned to the placebo group. No-reflow occurred in 33.3% of the placebo group, compared to none of the verapamil patients (p = 0.10). The use of intragraft verapamil prior to SVG PCI increased flow rate in the vessel as assessed by TIMI frame count (53.3 22.4% faster in the verapamil group versus 11.5 38.9% in the placebo group; p = 0.016). There was a trend toward improved myocardial perfusion as assessed by TMPG. There was no difference in the incidence of cardiac biomarker release following PCI. CONCLUSIONS: Intragraft administration of verapamil prior to saphenous vein graft PCI reduces no-reflow and is associated with a trend toward improved myocardial perfusion.
Authors:
Andrew D Michaels; Mark Appleby; Matthew H Otten; Kent Dauterman; Thomas A Ports; Tony M Chou; C Michael Gibson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  14     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-03     Completed Date:  2002-08-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-302     Citation Subset:  IM    
Affiliation:
University of California at San Francisco Medical Center, Division of Cardiology, 505 Parnassus Avenue, Box 0124, San Francisco, CA 94143-0124, USA. andrewm@itsa.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography
Female
Graft Occlusion, Vascular / drug therapy*,  radiography,  surgery*
Heart Catheterization
Humans
Male
Middle Aged
Myocardial Reperfusion / methods*
Preoperative Care
Regional Blood Flow
Saphenous Vein / transplantation
Treatment Outcome
Vasodilator Agents / administration & dosage*
Verapamil / administration & dosage*
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 52-53-9/Verapamil
Comments/Corrections
Comment In:
J Invasive Cardiol. 2002 Jun;14(6):303-4   [PMID:  12042619 ]

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


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