This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.
Intracoronary β-Blocker Before Percutaneous Intervention Protects Myocardium
Intracoronary administration of the β-blocker propanolol before percutaneous intervention protected myocardium during the procedure, said researchers from The University of Texas Medical Branch at Galveston in this week’s issue of the journal Circulation (Circulation. 2003;107:2914–2919OpenUrlCrossRefPubMed).
Researchers led by Fen Wei Wang, MD, of UTMB, randomly assigned 150 patients scheduled for percutaneous intervention to receive intracoronary percutaneous intervention or placebo. Propanolol was delivered before the inflation of the angioplasty balloon using an intracoronary catheter. The scientists monitored creatine kinase–MB and troponin T in the patients during the first 24 hours after the procedure. Patients were monitored for 30 days for short-term adverse events.
They found that 36% of patients in the placebo group and 17% of those in the propanolol group showed evidence of myocardial infarction as measured by elevations of creatine kinase–MB. Higher levels of troponin T were seen in 33% of the placebo patients and only 13% of the patients who received β-blocker.
After 30 days, 40% of the patients in the placebo group had either died, suffered a myocardial infarction right after the procedure, suffered a non–Q-wave myocardial infarction after hospitalization for the procedure, or undergone an urgently required revascularization of the lesion that required treatment in the first procedure. By comparison, only 18% of the patients who received the propanolol fell into the above group.
The researchers concluded: …