Effects of percutaneous transluminal coronary recanalization in acute myocardial infarction Masao Yasuno 1 , Tomoya Onodera 1 , Reiji Kawata 1 , Moriharu Ishida 1 , Hiroyuki Ohashi 1 , Yoshihiko Saito 1 , Hiraki Tanaka 1 1Division of Internal Medicine, Shizuoka Rosai Hospital pp.79-84
Published Date 1984/1/15
DOI https://doi.org/10.11477/mf.1404204377
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Coronary arteriographies were performed in 25 consecutive patients with acute myocardial infarc-tion 4.14-1.8 hours (mean±SD) after the onset of symptoms. Twenty patients had total occlusion or subtotal occlusion with poor distal flow of an infarct-related coronary artery, while remaining 5 had severe proximal stenosis without poor distal flow. In 14 patients (70%), the occluded coronary artery was successfully recanalized by an intracoronary infusion of nitroglycerin or urokinase. All patients were administered GIK solution containing 313 gm glucose, 40 unit regular insulin and 50 mEq potassium per liter at 67 ml per hour for 76 hours. Repeat arteriography 30-56 days later revealed a patent coronary artery in 8 (Group A) of 13 successfully recanalized patients.

The left ventricular ejection fraction had signi-ficantly improved in Group A, from 54±12% to 74±9% (p<0.01). In contrast, the ejection fraction did not show significant increase in patients with unsuccessful recanalization or late reocclusion, from 43118% to 46±14% (p>0.10).

These data suggest that successful early recanalization with sustained patency of an infarct-related coronary artery has a beneficial effect on the extent of myocardial necrosis as estimated from contrast left ventriculogram. And we belive that GIK solution can enhance the beneficial effect of PTCR on left ventricular function in acute myocardial infarction.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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