Open AccessChronic pretreatment of ACEI reduces no‐reflow in patients with acute myocardial infarction treated with primary angioplasty
Author(s) -
Zhao JingLin,
Yang YueJin,
Zhang YuanHui,
Pei WeiDong,
Sun YuHua,,
Chen JiLin,
Gao RunLin
Publication year - 2007
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20060
Subject(s) - medicine , timi , cardiology , myocardial infarction , ejection fraction , no reflow phenomenon , revascularization , angioplasty , angina , thrombus , percutaneous coronary intervention , heart failure
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. Copyright © 2007 Wiley Periodicals, Inc.