Abstract 17019: IVUS Predictors of the Improvement of Slow Flow After Intracoronary Nitroprusside in the Percutaneous Coronary Intervention
The microcirculatory flow is the key to restoring the myocardial tissue perfusion. The beneficial effects of better restoration of the epicardial coronary flow (TIMI flow grade 3 fast or 4: corrected TIMI frame count, CTFC < 23) following percutaneous coronary intervention (PCI) were reported. Previous studies have shown that intracoronary nitroprusside injection (ICNTP) is effective for slow flow after PCI. We investigated the relationship between the improvement of CTFC after ICNTP and pre-intervention intravascular ultrasound (IVUS) findings in 112 patients with slow flow following PCI. IVUS assessment included (1) plaque area, (2) arc of calcium and (3) presence of attenuated plaque (plaque with deep echo attenuation, but without calcification). The contribution of the three IVUS findings and distal protection was tested through multiple logistic regression analysis.
Results: The mean CTFC after ICNTP was decreased significantly from 48.4±18.9 to 26.0±10.0 (p<0.0001). Multivariate logistic regression analysis showed that distal protection and plaque area were independent predictors of TIMI3 Fast or 4 after ICNTP.
Conclusions: ICNTP following PCI improved CTFC. In patients with large plaque area, the effect of ICNTP was limited and the use of distal protection should be considered.
- © 2012 by American Heart Association, Inc.