open access

Vol 20, No 3 (2013)
Original articles
Published online: 2013-06-01
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Intravenous versus intracoronary bolus of glycoprotein IIb/IIIa inhibitor administration during primary percutaneous coronary intervention on long-term left ventricular systolic and diastolic function

Pierpaolo Pellicori, Concetta Torromeo, Francesco Barillà, Enrico Mangieri, Antonietta Evangelista, Giovanni Truscelli, Pierluigi Costanzo, Angela Hoye, Kenneth Wong
DOI: 10.5603/CJ.2013.0077
·
Cardiol J 2013;20(3):310-317.

open access

Vol 20, No 3 (2013)
Original articles
Published online: 2013-06-01

Abstract

Background: In primary percutaneous coronary intervention (PCI), glycoprotein (GP) IIb/IIIa inhibitors are often given in order to attain and maintain better myocardial perfusion. Wetested the hypothesis that intracoronary (IC) bolus of GP IIb/IIIa inhibitors might producea greater improvement in left ventricular (LV) systolic and diastolic function than an intravenous(IV) bolus.

Methods and results: Seventy seven patients undergoing primary PCI for their firstST elevation myocardial infarction (STEMI) were randomly assigned to either an IC or IVbolus of GP IIb/IIIa inhibitor, followed by IV infusion. Compared with the echocardiographic findings within 3 days after PCI, LV ejection fraction was higher at 1 year, with no significant differences between the IV and IC groups (IV: 44% vs. 49%, p = 0.001; IC: 43% vs. 48%,p < 0.001). LV diastolic function (E/E’) did not significantly change at 1 year by either approach.

Conclusions: LV systolic function improved by a similar magnitude following primary PCI, with either IC or IV bolus administration of GP IIb/IIIa inhibitor therapy. However, no significant changes were observed in LV diastolic function.

Abstract

Background: In primary percutaneous coronary intervention (PCI), glycoprotein (GP) IIb/IIIa inhibitors are often given in order to attain and maintain better myocardial perfusion. Wetested the hypothesis that intracoronary (IC) bolus of GP IIb/IIIa inhibitors might producea greater improvement in left ventricular (LV) systolic and diastolic function than an intravenous(IV) bolus.

Methods and results: Seventy seven patients undergoing primary PCI for their firstST elevation myocardial infarction (STEMI) were randomly assigned to either an IC or IVbolus of GP IIb/IIIa inhibitor, followed by IV infusion. Compared with the echocardiographic findings within 3 days after PCI, LV ejection fraction was higher at 1 year, with no significant differences between the IV and IC groups (IV: 44% vs. 49%, p = 0.001; IC: 43% vs. 48%,p < 0.001). LV diastolic function (E/E’) did not significantly change at 1 year by either approach.

Conclusions: LV systolic function improved by a similar magnitude following primary PCI, with either IC or IV bolus administration of GP IIb/IIIa inhibitor therapy. However, no significant changes were observed in LV diastolic function.

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Keywords

ST elevation myocardial infarction, primary percutaneous coronary intervention, intracoronary GP IIb/IIIa inhibitors, diastolic function

About this article
Title

Intravenous versus intracoronary bolus of glycoprotein IIb/IIIa inhibitor administration during primary percutaneous coronary intervention on long-term left ventricular systolic and diastolic function

Journal

Cardiology Journal

Issue

Vol 20, No 3 (2013)

Pages

310-317

Published online

2013-06-01

DOI

10.5603/CJ.2013.0077

Bibliographic record

Cardiol J 2013;20(3):310-317.

Keywords

ST elevation myocardial infarction
primary percutaneous coronary intervention
intracoronary GP IIb/IIIa inhibitors
diastolic function

Authors

Pierpaolo Pellicori
Concetta Torromeo
Francesco Barillà
Enrico Mangieri
Antonietta Evangelista
Giovanni Truscelli
Pierluigi Costanzo
Angela Hoye
Kenneth Wong

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