Effects of Different Vasodilators on Coronary No-reflow During primAry percuTaneous Coronary intErvention in Patients With Acute Myocardial Infarction

Reversal of No-reflow/Slow-flow During Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction--a Prospective Randomized Study Comparing Intracoronary Infusion of Diltiazem, Verapamil and Nitroglycerin

The purpose of this study is to evaluate the efficacy of three different vasodilators including diltiazem, verapamil and nitroglycerin for reversal of no-reflow/slow-flow during direct percutaneous coronary intervention for acute myocardial infarction.

No-reflow/slow-flow is a frequent observation during direct PCI for AMI and associated with a poor clinical outcome. The present pharmacological management involves the use of different vasodilators including nitrates, verapamil, adenosine and nicorandil. But no randomized trial has been conducted to assess any of these agents, or to determine the appropriate dosage. This prospective randomized study aimed to confirm favorable effects of diltiazem on no-reflow/slow-flow during direct PCI for AMI compared with verapamil and nitroglycerin.

Inclusion Criteria:

• Clinical diagnosis of acute myocardial infarction
• Vessel TIMI flow < grade Ⅲ post-PCI

Exclusion Criteria:

• Heart failure of New York Heart Association (NYHA) class Ⅲ to class Ⅳ
• Sick sinus syndrome
• Atrioventricular block (grade Ⅱ and above)
• SBP ≤ 90mmHg or cardiogenic shock
• Heart Rate ≤60 bpm
• Pregnancy
• Renal or hepatic failure