Efficiency and Safety of Intracoronary Epinephrine Administration in Patients With ST-Elevation Myocardial Infarction With Refractory Coronary No-Reflow

Studies assessing the treatment of refractory no-reflow in patients with ST-elevation myocardial infarction (STEMI) are limited to clinical cases and pilot studies. This study aimed to evaluate the efficacy and safety of intracoronary adrenaline administration in such patients. Ninety consecutive pa...

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Bibliographic Details
Published in:The American journal of cardiology 2024-09, Vol.226, p.118-127
Main Authors: Ryabov, Vyacheslav, Dil, Stanislav, Vyshlov, Evgeny, Mochula, Olga, Kercheva, Maria, Baev, Andrey, Gergert, Egor, Maslov, Leonid
Format: Article
Language:English
Subjects:
Cardiology
Catheters
Edema
Effectiveness
Electrocardiography
Epinephrine
Glycoproteins
Heart attacks
Informed consent
intracoronary adrenaline administration
Magnetic resonance imaging
microvascular obstruction
Microvasculature
Myocardial infarction
no-reflow phenomenon
Patients
Performance evaluation
Thrombolysis
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Summary:Studies assessing the treatment of refractory no-reflow in patients with ST-elevation myocardial infarction (STEMI) are limited to clinical cases and pilot studies. This study aimed to evaluate the efficacy and safety of intracoronary adrenaline administration in such patients. Ninety consecutive patients with refractory coronary no-reflow during percutaneous coronary intervention (PCI) were prospectively included after the initial failure of conventional treatment. They were randomized into 2 groups: 45 patients in Group 1 received adrenaline, and 45 patients in Group 2 (control) received conventional treatments alone. After intracoronary drug administration, the adrenaline group demonstrated significantly higher rates of coronary flow restoration in the infarct-related artery to the level of thrombolysis in myocardial infarction grade 3 (56% vs 29% [p = 0.01]) and resolution of STEMI >50% after PCI (78% vs 36% [p
ISSN:0002-9149
1879-1913
1879-1913
DOI:10.1016/j.amjcard.2024.07.011