Effects of glycoprotein iib/iiia inhibition on microvascular flow after coronary reperfusion

Kunichika, Hideki; Ben‐Yehuda, Ori; Lafitte, Stéphane; Kunichika, Naomi; Peters, Barry; DeMaria, Anthony N.

doi:10.1016/j.jacc.2003.08.040

Cited by 100 publications

(67 citation statements)

References 38 publications

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“…Using quantitative myocardial contrast echocardiographic study, tirofiban also improved microvascular flow and reduced the infarct area after coronary occlusion/reperfusion in open-chest dogs. 12) This ex vivo observation was also evident clinically. For example, intracoronary administration of abciximab, 13) a monoclonal antibody directed against the glycoprotein IIb/IIIa receptor, and tirofiban, 14) a synthetic nonpeptide small-molecule platelet glycoprotein IIb/ IIIa receptor inhibitor, were shown to be able to dissolve an intracoronary thrombus, although both are not thrombolytic agents.…”

Section: Discussionmentioning

confidence: 67%

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

et al. 2005

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SUMMARYNo-reflow phenomenon is frequently observed during percutaneous coronary intervention in patients with acute coronary syndrome. It may jeopardize hemodynamic status or result in ischemic chest pain in these patients. Currently, there is no adequate solution for this problem. We report our experience with an acute coronary syndrome patient who developed no-reflow phenomenon associated with ST segment elevation and shock after percuteneous coronary balloon dilatation and stent deployment. Intracoronary administration of tirofiban immediately restored the coronary flow of the target vessel, and the disastrous condition reversed. Our experience suggests that intracoronary administration of tirofiban can be considered as an option in case of no-reflow phenomenon during percutaneous coronary intervention. (Int Heart J 2005; 46: 139-145)

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Section: Discussionmentioning

confidence: 67%

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

et al. 2005

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“…In a study carried out by Assali et al (39), 5.9% of the patients administered with intracoronary adenosine were observed with no-reflow, while the ratio of patients with noreflow was 28.6% in the group not receiving adenosine. Kunichika et al (40) reported that tirofiban, a glycoprotein receptor inhibitor, decreased the extent of infarct and no-reflow incidence. Lower incidence of no-reflow phenomenon has been reported in patients undergoing direct stenting without predilation (41).…”

Section: Discussionmentioning

confidence: 99%

Relationship between no-reflow phenomenon and serotonin levels in patients with acute ST-elevation myocardial infarction who underwent primary percutaneous intervention

Topsakal¹,

Kaya²,

Karakaya³

et al. 2010

Anadolu Kardiyol Derg

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Objective: Our aim was to investigate the effects of serotonin, which is a severe vasoconstrictor agent, on the occurrence of no-reflow phenomenon. Methods: In this cross-sectional controlled study, 40 patients, admitted to our clinic with chest pain in the first 12 hours and underwent primary percutaneous coronary intervention because of acute myocardial infarction were enrolled. Patients with TIMI 0 grade basal flow and normal post-procedure flow were included in group 1 and patients with flow grade TIMI ≤were enrolled in group 2. To measure the serotonin levels, blood samples were collected from the coronary ostium before the procedure. Results: In group 1, there were 25 patients (20 males, 5 females) and the mean age was 58±11 years; in group 2 there were 15 patients (13 males, 2 females) and the mean age was 62±8 years. The mean serotonin level in platelet in group 1 was 476±208 ng/10 9 platelet and in group 2-542±273 ng/10 9 platelet. The difference was not statistically significant (p=0.39). When we compared the serum serotonin levels, it was 41.4±40.8 ng/ml for group 1, but 66.7±45.7 ng/ml for group 2. Although the serum serotonin levels were higher in group 2, the difference was not statistically significant (p=0.07). Conclusion: There was no effect of serotonin level in the development of no-reflow, in patients to whom primary coronary percutaneous intervention was applied. (Anadolu Kardiyol Derg 2010; 10: 253-9) Key words: No-reflow phenomenon, serotonin, vasoconstriction, myocardial infarction ÖZET Amaç: Çalışmamızın amacı, vazokonstriktör bir ajan olan serotoninin no-reflow fenomeni gelişimi üzerine olan etkisini araştırmaktı. Yöntemler: Bu enine-kesitli kontrollü çalışmaya akut miyokart enfarktüsü nedeniyle, göğüs ağrılarının ilk 12 saati içinde kliniğimize başvuran ve primer perkütan girişim uygulanan 40 hasta alındı. İşlem öncesi akım TIMI 0 iken işlem sonrası akım normal olanlar grup 1'i, işlem sonrası akım TIMI ≤2 olanlar grup 2'yi oluşturdu. Serotonin düzeyini ölçmek için işlem öncesi koroner ostiumdan kan alındı. Bulgular: Grup 1'de 25 hasta (20 erkek, 5 kadın) vardı, ortalama yaş 58±11 yıl idi; Grup 2' de 15 hasta vardı (13 erkek, 2 kadın) ve ortalama yaş 62±8 yıl idi. Grup'1 de trombosit içi ortalama serotonin düzeyi 476±208 ng/10 9 trombosit ve grup 2'de 542±273 ng/10 9 trombosit idi. Fark istatistiksel olarak anlamlı değildi (p=0.39). Serum serotonin düzeyi grup'1 de 41.4±40.8 ng/ml, grup'2 de 66.7±45.7 ng/ml olarak bulundu. Aradaki fark anlamlı değildi (p=0.07). Relationship between no-reflow phenomenon and serotonin levels in patients with acute ST-elevation myocardial infarction who underwent primary percutaneous intervention Akut ST yükselmeli miyokart enfarktüsü nedeniyle primer perkütan girişim uygulanan hastalarda no-reflow fenomeni ile serotonin düzeyi arasındaki ilişki

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“…This no-reflow phenomenon is thought to be the result of microvascular obstruction (17)(18)(19). This phenomenon is a marker of more extensive myocardial tissue damage and has been proven to be associated with poorer functional recovery, an increased frequency of heart failure and poor survival (4,20). This is why there is a growing need to establish a reliable marker of myocardial perfusion.…”

Section: Discussionmentioning

confidence: 99%

Myocardial perfusion assessed by contrast echocardiography correlates with angiographic perfusion parameters in patients with a first acute myocardial infarction successfully treated with angioplasty

Tomaszuk‐Kazberuk

Sobkowicz

Kamiński

et al. 2008

Canadian Journal of Cardiology

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Effects of glycoprotein iib/iiia inhibition on microvascular flow after coronary reperfusion

Cited by 100 publications

References 38 publications

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

Restoration of Normal Coronary Flow With Tirofiban by Intracoronary Administration for No-reflow Phenomenon After Stent Deployment

Relationship between no-reflow phenomenon and serotonin levels in patients with acute ST-elevation myocardial infarction who underwent primary percutaneous intervention

Myocardial perfusion assessed by contrast echocardiography correlates with angiographic perfusion parameters in patients with a first acute myocardial infarction successfully treated with angioplasty

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