Effect of chronic pretreatment of angiotensin-converting receptor blocker on no-reflow phenomenon in patients with acute myocardial infarction undergoing percutaneous coronary intervention

Cardiovascular Therapeutics, 04/25/2012

Chronic pre–treatment of angiotensin receptor blocker (ARB) is associated with the reduction of the no–reflow phenomenon in patients with reperfused acute myocardial infarction (AMI) and could preserve microvascular integrity after AMI independent of blood pressure lowering, which may contribute to better functional recovery.

Methods

  • Authors investigated 276 consecutive patients with AMI undergoing successful primary percutaneous coronary intervention (PCI).
  • No–reflow was defined as Thrombolysis in Myocardial Infarction (TIMI) flow grade <3, which was determined by the TIMI frame count method using angiographic images obtained just after PCI and stenting.

Results

  • Compared with patients without ARB treatment, patients with ARB had more frequently hypertension and ST resolution (P<0.05 respectively), but no significant difference was found in the other clinical characteristics (age, sex, Hyperlipidaemia, Diabetes mellitus, etc) between the two groups.
  • A total of 51 patients receiving chronic ARB treatment before admission have lower incidence of the no–reflow phenomenon than those without chronic ARB treatment (8.7% and 26.7%, P = 0.003).
  • However, the incidence of the no–reflow phenomenon between the patients with and without hypertension had no significant difference.
  • Multivariable logistic regression analysis revealed that ARB pretreatment was a significant predictor of the no–reflow phenomenon, whereas blood pressure was found to be insignificant.

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