Chronic pretreatment of ACEI reduces no-reflow in patients with acute myocardial infarction treated with primary angioplasty.

Abstract:

BACKGROUND:In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI. METHOD AND RESULTS:A total of 259 consecutive patients who underwent primary angioplasty for a first AMI were studied. No-reflow was defined as a TIMI flow grade < 3. The no-reflow phenomenon was found in 33 of 259 patients. There were no significant differences in clinical characteristics between the patients with and without ACEI pretreatment. However, the 47 patients receiving chronic ACEI treatment before admission had lower incidence of the no-reflow than those without it (4.2 and 14.6%, p<0.05). Multivariable logistic regression analysis revealed that absence of ACEI pretreatment was a significant predictor of the no-reflow along with absence of preinfarction angina, complete occlusion of the culprit lesion, high-burden thrombus, ejection fraction on admission, number of Q-waves, absence of statin pretreatment, and anterior AMI. CONCLUSION:Pretreatment with ACEI could preserve the microvascular integrity after acute myocardial infarction in humans.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Zhao JL,Yang YJ,Zhang YH,Pei WD,Sun YH,Chen JL,Gao RL

doi

10.1002/clc.20060

subject

Has Abstract

pub_date

2007-03-01 00:00:00

pages

130-4

issue

3

eissn

0160-9289

issn

1932-8737

journal_volume

30

pub_type

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