الفهرس 
Acute ST-segment Elevation Myocardial Infarction – Definition and PathogenesisOnly 14 pages are availabe for public view
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Abstract
This is a Randomized controlled prospective study to see the effect of intracoronary vasodilators during primary PCI of acute anterior STEMI on incidence of arrhythmic events.
The study was conducted on 60 patients with their 1st acute coronary syndrome, and they were diagnosed as having acute anterior ST segment elevation myocardial infarction and underwent primary percutaneous coronary intervention. They were randomized into three groups and received intracoronary adenosine, verapamil or normal saline in a control one.
Arrhythmic events in the form of different types of tachy- or bradyarrhythmias were recorded on admission by baseline ECG, during PCI procedure, and then throughout hospital stay by continuous CCU monitor and by holter recording on 3rd and 4th day of admission. The three groups were comparable as regards arrhythmic events with no statistical difference; however there was a trend towards adenosine and verapamil especially during hospital stay with no arrhythmia recorded.
For procedural outcome, MBG showed a highly significant statistical difference for adenosine compared to verapamil and control with almost all cases in adenosine group showed MBG III. Also fewer cases in adenosine group needed PTCA before stenting with a significant statistical difference toward it. As regards no reflow phenomenon, TIMI flow pre and post procedure and other angiographic assessment, the three groups were comparable.
Baseline demographic data showed a significant difference toward verapamil group as regards smoking and insulin therapy, where the rest of demographic, clinical and electrocardiographic data were comparable among the groups.
Echocardiographic data showed a significant difference toward adenosine group regarding LVEDD and LVESD.
Based on the results of our study, the use of adenosine and verapamil as coronary vasodilators during primary PCI is advised as it may reduce arrhythmic events, and it showed better angiographic outcome regarding MBG with adenosine.
Future studies are recommended to better evaluate the rewarding outcomes of these vasodilators on reducing arrhythmia, and better angiographic outcome in primary PCI.