Effect of microcatheter injection of nitroglycerin on coronary artery no-reflow in patients with acute ST-segment elevation myocardial infarction
Wang Xinguo
Ye Ming
Zu Xiaolin
Wang Xu
Zeng Yujie
Abstract：Objective To observe the effect of nitroglycerin injection by microcatheter on the immediate efficacy and short-term prognosis in ST-segment elevation myocardial infarction ( STEMI ) patients suffering from coronary artery no-reflow during percutaneous coronary intervention( PCI) . Methods A total of 104 patients with STEMI who had coronary artery no-reflow during PCI were enrolled from July 2016 to December 2017 in Beijing Anzhen Hospital, Capital Medical University. The patients were randomly divided into observation group treated by microcatheter injection of nitroglycerin 200 μg and control group treated by nitroglycerin injection using guiding catheter, with 52 cases in each group. Priminary endpoints were thrombolysis in myocardial infarction( TIMI) flow grade and corrected TIMI frame count(CTFC) after nitroglycerin injection. Secondary endpoints included perioperative complications, adverse cardiovascular events such as recurrent myocardial infarction, target vessel revascularization, death, and cardiac function indicators including left ventricular ejection fraction ( LVEF ) and left ventricular end-diastolic diameter( LVEDD) in 3 months after PCI. Results After nitroglycerin injection, the success rate of correcting no-reflow(TIMI grade 3) in observation group was higher[78. 8％(41/52) vs 53. 8％(28/52)] and CTFC was less[(27 ± 18)frames vs (39 ± 19)frames] than those in control group(both P<0. 01). No significant differences were observed regarding perioperative hypotension, bradycardia and ventricular tachycardia/ventricular fibrillation between groups(all P>0. 05). No significant differences were documented in 3-month revascularization rate, mortality, LVEF and LVEDD between groups ( all P >0. 05 ) . Conclusion Microcatheter injection of nitroglycerin can immediately correct coronary no-reflow in STEMI patients undergoing PCI, but it shows no significant benefit for the short-term prognosis.
Keywords：Acute ST-segment elevation myocardial infarctionNitroglycerinCoronary no-reflow
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 1454-1457 )