Effects of abciximab on microvascular integrity and left ventricular functional recovery in patients with acute infarction treated by primary coronary angioplasty

被引:76
作者
Petronio, AS
Rovai, D
Musumeci, G
Baglini, R
Nardi, C
Limbruno, U
Palagi, C
Volterrani, D
Mariani, M
机构
[1] Univ Pisa, CardioThorac Dept, Osped Cisanello, I-56124 Pisa, Italy
[2] Inst Clin Physiol, CNR, Pisa, Italy
[3] Univ Pisa, Osped Santa Chiara, Oncol Dept, Pisa, Italy
关键词
contrast echocardiography; primary PTCA; myocardial infarction; platelet inhibitors; coronary microcirculation;
D O I
10.1016/S0195-668X(02)00324-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aim To investigate the effect of abciximab on microvascular integrity and left ventricular (LV) functional recovery in patients with acute myocardial infarction (MI) treated by primary coronary angioplasty (PTCA). Methods and results Thirty-one patients (27 mates; age 39-76 years) with first, acute MI (<6 h after onset) were randomized to receive either abciximab + primary PTCA (n = 17) or primary PTCA atone (n = 14). Baseline characteristics of the two groups were similar. Myocardial reperfusion was studied shortly after PTCA by corrected TIMI frame count (cTFC) and intracoronary myocardial contrast echocardiography (MCE), after 48 h by intravenous MCE using intermittent, harmonic power Doppler, and after 1 month by intravenous MCE and 99 mTc-tetrofosmin SPECT. The patients treated with abciximab showed a shorter cTFC (23+/-4 vs 30+/-9 frames; P<0.05), a more preserved microvascular integrity shortly after PTCA (77% vs 55%; P<0.01), after 48 h (86% vs 50%; P<0.005) and at 1-month follow-up (86% vs 54% by MCE, P<0.001, and 68% vs 60% by SPECT, P<0.005) than patients treated with PTCA atone. Abciximab patients also showed a better recovery of LV function, as demonstrated by greater reduction in wall motion score index (1.4+/-0.3 vs 1.5+/-0.2; P<0.05) and increase in LV ejection fraction (53+/-7% vs 48+/-5%; P<0.001). Conclusions Abciximab improves microvascular perfusion and LV functional recovery in primary PTCA. (C) 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:67 / 76
页数:10
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