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Catheter Cardiovasc Interv. 2006 Nov;68(5):671-6.

Efficacy of intracoronary nicardipine in the treatment of no-reflow during percutaneous coronary intervention.

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1
Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

Abstract

OBJECTIVES:

The goal of this study was to evaluate the safety and efficacy of nicardipine in reversing no-reflow during percutaneous coronary intervention (PCI).

BACKGROUND:

No-reflow is a common complication of PCI in patients with acute coronary syndromes or venous bypass graft disease. Although nicardipine has an attractive pharmacological profile and has been used clinically to treat no-reflow, there is a paucity of published data regarding its effectiveness in this setting.

METHODS:

We conducted a retrospective analysis of 72 consecutive patients who received intracoronary nicardipine to reverse no-reflow during coronary intervention. Qualitative TIMI flow grade and quantitative TIMI frame count methods were used to assess the efficacy of nicardipine.

RESULTS:

A mean of 460 +/- 360 mcg of intracoronary nicardipine was used. No-reflow was successfully reversed with complete restoration of TIMI 3 flow in 71 of 72 patients (98.6%). TIMI flow grade improved from 1.65 +/- 0.53 prior to nicardipine to 2.97 +/- 0.24 after treatment (P < 0.001). TIMI frame count decreased from 57 +/- 40 at the time of no-reflow to 15 +/- 12 after nicardipine administration (P < 0.001). Nicardipine therapy was well tolerated without adverse hemodynamic or chronotropic effects.

CONCLUSIONS:

In this largest series to date, intracoronary nicardipine was demonstrated to be a safe and highly effective pharmacological agent to reverse no-reflow during PCI.

PMID:
17034064
DOI:
10.1002/ccd.20885
[Indexed for MEDLINE]
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