on May 27, 2003
Published online before print May 27, 2003, doi: 10.1161/01.CIR.0000072787.25131.03
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on February 20, 2003
From the Division of Cardiology, University of Texas Medical Branch at Galveston, Tex. * To whom correspondence should be addressed. E-mail: buretsky{at}utmb.edu.
Background--Experimental studies have demonstrated that intravenous Methods and Results--Patients undergoing PCI (n=150) were randomly assigned in a double-blind fashion to receive IC propranolol (n=75) or placebo (n=75). Study drug was delivered before first balloon inflation via an intracoronary catheter with the tip distal to the coronary lesion. Biochemical markers were evaluated through the first 24 hours and clinical outcomes to 30 days. Evidence of MI with creatine kinase-MB elevation after PCI was seen in 36% of placebo and 17% of propranolol patients (P=0.01). Troponin T elevation was seen in 33% of placebo and 13% of propranolol patients (P=0.005). At 30 days, the composite end point of death, postprocedural MI, non-Q-wave MI after PCI hospitalization, or urgent target-lesion revascularization occurred in 40% of placebo versus 18% of propranolol patients (hazard ratio 2.14, 95% CI 1.24 to 3.71, P=0.004). Conclusions--IC administration of propranolol protects the myocardium during PCI, significantly reducing the incidence of MI and improving short-term clinical outcomes.
Accepted on February 26, 2003
Distal Myocardial Protection During Percutaneous Coronary Intervention With an Intracoronary
Fen Wei Wang MD, 
-Blocker
-blocker administration before coronary artery occlusion significantly reduces myocardial injury. Clinical studies have shown that intracoronary (IC) propranolol administration before percutaneous coronary intervention (PCI) delays myocardial ischemia. The present study tested the hypothesis that IC propranolol treatment protects ischemic myocardium from myocardial damage and reduces the incidence of myocardial infarction (MI) and short-term adverse outcomes after PCI.
Key words: angioplasty • beta-blockers, adrenergic • myocardial infarction
Related Article:
Circulation 2003 107: e9050-e9051.
This article has been cited by other articles:
 |
|
 |
|
  A. Nusca, R. Melfi, and G. Di Sciascio Review: Percutaneous coronary interventions and statins therapy Therapeutic Advances in Cardiovascular Disease, April 1, 2008; 2(2): 101 - 107. [Abstract] [PDF]
|
|
|
|
 |
|
 W. D Cahoon Jr and M. A Crouch Preprocedural Statin Therapy in Percutaneous Coronary Intervention Ann. Pharmacother., October 1, 2007; 41(10): 1687 - 1693. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Ibanez, S. Prat-Gonzalez, W. S. Speidl, G. Vilahur, A. Pinero, G. Cimmino, M. J. Garcia, V. Fuster, J. Sanz, and J. J. Badimon Early Metoprolol Administration Before Coronary Reperfusion Results in Increased Myocardial Salvage: Analysis of Ischemic Myocardium at Risk Using Cardiac Magnetic Resonance Circulation, June 12, 2007; 115(23): 2909 - 2916. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Bahrmann, G. S. Werner, G. Heusch, M. Ferrari, T. C. Poerner, A. Voss, and H. R. Figulla Detection of Coronary Microembolization by Doppler Ultrasound in Patients With Stable Angina Pectoris Undergoing Elective Percutaneous Coronary Interventions Circulation, February 6, 2007; 115(5): 600 - 608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Balian, M. Galli, C. Marcassa, G. Cecchin, M. Child, F. Barlocco, E. Petrucci, G. Filippini, R. Michi, and M. Onofri Intracoronary ST-Segment Shift Soon After Elective Percutaneous Coronary Intervention Accurately Predicts Periprocedural Myocardial Injury Circulation, October 31, 2006; 114(18): 1948 - 1954. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Atar, M. E. Korkmaz, I. A. Atar, O. Gulmez, B. Ozin, H. Bozbas, T. Erol, A. Aydinalp, A. Yildirir, M. Yucel, et al. Effects of metoprolol therapy on cardiac troponin-I levels after elective percutaneous coronary interventions Eur. Heart J., March 1, 2006; 27(5): 547 - 552. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Herrmann Peri-procedural myocardial injury: 2005 update Eur. Heart J., December 1, 2005; 26(23): 2493 - 2519. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Patti, G. Colonna, V. Pasceri, L. L. Pepe, A. Montinaro, and G. Di Sciascio Randomized Trial of High Loading Dose of Clopidogrel for Reduction of Periprocedural Myocardial Infarction in Patients Undergoing Coronary Intervention: Results From the ARMYDA-2 (Antiplatelet therapy for Reduction of MYocardial Damage during Angioplasty) Study Circulation, April 26, 2005; 111(16): 2099 - 2106. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Pasceri, G. Patti, A. Nusca, C. Pristipino, G. Richichi, G. Di Sciascio, and on behalf of the ARMYDA Investigators Randomized Trial of Atorvastatin for Reduction of Myocardial Damage During Coronary Intervention: Results From the ARMYDA (Atorvastatin for Reduction of MYocardial Damage during Angioplasty) Study Circulation, August 10, 2004; 110(6): 674 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Halkin, C. L. Grines, D. A. Cox, E. Garcia, R. Mehran, J. E. Tcheng, J. J. Griffin, G. Guagliumi, B. Brodie, M. Turco, et al. Impact of intravenous Beta-Blockade before primary angioplasty on survival in patients undergoing mechanical reperfusion therapy for acute myocardial infarction J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1780 - 1787. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. P. Faxon Beta-blocker therapy and primary angioplasty: What is the controversy? J. Am. Coll. Cardiol., May 19, 2004; 43(10): 1788 - 1790. [Full Text] [PDF]
|
|