<p><b>BACKGROUND</b>
No-reflow phenomenon during
percutaneous coronary intervention (PCI) for acute
myocardial infarction (AMI) is a predictive factor of continuous
myocardial ischemia,
ventricular remodeling and cardiac dysfunction, which is closely associated with a worse
prognosis. This study aimed to evaluate intracoronary
nitroprusside in the prevention of the
no-reflow phenomenon in AMI.</p><p><b>
METHODS</b>Ninety-two consecutive
patients with AMI,
who underwent primary PCI within 12 hours of onset, were randomly assigned to 2 groups intracoronary
administration of
nitroprusside (group A, n = 46), intracoronary
administration of
nitroglycerin (group B, n = 46). The angiographic results were observed. The real-
time myocardial
contrast echocardiography (RT-MCE), including contrast score index (CSI), wall
motion score index (WMSI), transmural contrast defect length (CDL) and serious WM abnormal length (WML) were recorded at 24 hours and 1 week post-PCI.
High sensitivity C-reactive protein (
Hs-CRP) was examined by immune rate
nephelometry. N-terminal prohormone
brain natriuretic peptide (NT-proBNP) was tested with
enzyme-linked immunosorbent assay.
Patients were followed up for six months.
Major adverse cardiac events (
MACE) were recorded.</p><p><b>RESULTS</b>The
incidence of final TIMI-3 flow in group A was much higher than that in Group B (P < 0.05), final corrected TIMI frame count (cTFC) in group A decreased significantly than that in group B (P < 0.01). The CSI, CDL/LV length, WMSI and WL/LV length in group A were significantly lower than that in group B (P < 0.01). Levels of
Hs-CRP and NT-proBNP at 1 week post-PCI decreased significantly in group A than that in group B (P < 0.01).
Patients were followed up for 6 months and the
incidence of
MACE in group A was significantly lower than that in group B (P < 0.05).</p><p><b>CONCLUSION</b>Intracoronary
nitroprusside can improve myocardial
microcirculation, leading to the decrease of the
incidence of
no-reflow phenomenon and better
prognosis.</p>