Title of article :
Intracoronary Enalaprilat to Reduce Microvascular Damage During Percutaneous Coronary Intervention (ProMicro) Study
Author/Authors :
Mangiacapra، نويسنده , , Fabio and Peace، نويسنده , , Aaron J. and Di Serafino، نويسنده , , Luigi and Pyxaras، نويسنده , , Stylianos A. and Bartunek، نويسنده , , Jozef and Wyffels، نويسنده , , Eric and Heyndrickx، نويسنده , , Guy R. and Wijns، نويسنده , , William and De Bruyne، نويسنده , , Bernard and Barbato، نويسنده , , Emanuele، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2013
Pages :
7
From page :
615
To page :
621
Abstract :
Objectives tudy investigated the influence of intracoronary enalaprilat on coronary microvascular function and peri-procedural outcome measures in patients with stable angina undergoing percutaneous coronary intervention (PCI). ound oronary angiotensin-converting enzyme inhibitors have been shown to relieve myocardial ischemia in stable patients and to improve epicardial flow in patients with ST-segment elevation myocardial infarction. Yet, it is still unclear whether these effects are mediated by a modulation of the coronary microcirculation. s domly assigned 40 patients to receive either an intracoronary bolus of enalaprilat (50 μg) or placebo before elective PCI. The index of microvascular resistance was measured at baseline, 10 minutes after study drug administration, and after PCI. High-sensitivity cardiac troponin T was measured as a marker of myocardial injury. s on of enalaprilat resulted in a significant reduction in index of microvascular resistance (27 ± 11 at baseline vs. 19 ± 9 after drug vs. 15 ± 8 after PCI), whereas a significant post-procedural increase in index of microvascular resistance levels was observed in the placebo group (24 ± 15 at baseline vs. 24 ± 15 after drug vs. 33 ± 19 after PCI). Index of microvascular resistance levels after PCI were significantly lower in the enalaprilat group (p < 0.001). Patients pre-treated with enalaprilat also showed lower peak values (mean: 21.7 ng/ml, range: 8.2 to 34.8 ng/ml vs. mean: 32.3 ng/ml, range: 12.6 to 65.2 ng/ml, p = 0.048) and peri-procedural increases of high-sensitivity cardiac troponin T (mean: 9.9 ng/ml, range: 2.7 to 19.0 ng/ml vs. mean: 26.6 ng/ml, range: 6.3 to 60.5 ng/ml, p = 0.025). sions oronary enalaprilat improves coronary microvascular function and protects myocardium from procedure-related injury in patients with coronary artery disease undergoing PCI. Larger studies are warranted to investigate whether these effects of enalaprilat could result into a significant clinical benefit.
Keywords :
Angiotensin-converting enzyme inhibitors , Coronary Artery Disease , Coronary intervention , Coronary microvascular function
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
2013
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
1755636
Link To Document :
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