| 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. | |
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MedLine Citation:
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PMID: 12042618 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 14 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2002 Jun |
Date Detail:
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Created Date: 2002-06-03 Completed Date: 2002-08-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 299-302 Citation Subset: IM |
Affiliation:
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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 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Vasodilator Agents; 52-53-9/Verapamil |
| Comments/Corrections | |
Comment In:
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J Invasive Cardiol. 2002 Jun;14(6):303-4
[PMID:
12042619
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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