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首页> 外文期刊>The Journal of pharmacy technology: jPT : official publication of the Association of Pharmacy Technicians >Intracoronary Vasodilators for the No-Reflow Phenomenon
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Intracoronary Vasodilators for the No-Reflow Phenomenon

机译：冠状动脉内血管舒张剂的无回流现象

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Objective: To review the literature relating to the use of intracoronary vasodilators to prevent and/or treat the no-reflow phenomenon in patients undergoing percutaneous coronary intervention (PCI).Data Sources: A literature search was conducted using MEDLINE (1966-March 2008) and Science Citation Index (1945-March 2008) using the search terms vasodilators, no-reflow, and intracoronary.Study Selection and Data Extraction: English-language clinical trials and case series were selected from articles retrieved. References of reviewed articles were examined for additional sources. Studies relating to the use of intracoronary vasodilators in the prevention and/or treatment of no-reflow in PCI were evaluated for safety and efficacy data. Articles relating to agents not available in the US were excluded.Data Synthesis: Evidence of intracoronary adenosine's utility in no-reflow treatment is limited. Its use in no-reflow prevention was associated with outcomes ranging from no difference to nearly an 88% reduction in no-reflow development; the drug was generally well tolerated. No-reflow treatment with intracoronary verapamil improved flow in 87-100% of cases. Preventive trials with verapamil failed to demonstrate efficacy. Atrioventricular block requiring treatment was the most commonly reported adverse event with intracoronary verapamil. Literature on intracoronary diltiazem and intracoronary nicardipine is limited. Both agents produced greater than 95% efficacy in no-reflow treatment, while prevention studies found no-reflow developing in less than 4% of patients. Although adverse event reporting was limited, hemodynamic instability was noted in patients receiving diltiazem. Response rates ranged from 73% to 100% when intracoronary nitroprusside was studied as treatment for no-reflow associated with acute myocardial infarction (AMI). Systemic hypotension was noted with nitroprusside administration.Conclusions: The available data are predominately from case series and retrospective reviews. Prevention of no-reflow with intracoronary vasodilators in elective PCI is not warranted. Nitroprusside should be considered first-line treatment in no-reflow associated with AMI.
机译：目的：回顾有关使用冠状动脉内血管扩张剂预防和/或治疗经皮冠状动脉介入治疗（PCI）患者无复流现象的文献资料来源：使用MEDLINE进行文献检索（1966年3月至2008年3月）和科学引文索引（1945-March，2008）使用搜索词血管扩张剂，无复流和冠状动脉内。研究选择和数据提取：从检索到的文章中选择英语临床试验和病例系列。审查了已审阅文章的参考文献以获取其他来源。评价了与使用冠状动脉内血管扩张剂预防和/或治疗PCI无复流有关的研究的安全性和有效性数据。数据综合：冠状动脉内腺苷在无复流治疗中的实用性的证据有限。它在无回流预防中的应用与无差异至无回流发展减少近88％的结果相关;该药通常耐受性良好。冠状动脉内维拉帕米的无复流治疗可改善87-100％的病例的血流。维拉帕米的预防性试验未能证明疗效。需要治疗的房室传导阻滞是冠状动脉内维拉帕米最常见的不良事件。关于冠状动脉内地尔硫卓和冠状动脉内尼卡地平的文献有限。两种药物在无复流治疗中均产生超过95％的功效，而预防研究发现，少于4％的患者无复流发生。尽管不良事件报告有限，但接受地尔硫卓的患者血流动力学不稳定。当研究冠状动脉内硝普钠作为急性心肌梗死（AMI）相关的无复流治疗时，缓解率从73％到100％不等。结论：硝普钠给药可引起全身性低血压。结论：现有数据主要来自病例系列和回顾性研究。没有必要在择期PCI中使用冠状动脉内血管扩张剂预防无复流。硝普钠应被视为与AMI相关的无复流的一线治疗。

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