Related Experiment Video

Updated: Oct 6, 2025

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

5.3K

Intracoronary eptifibatide with vasodilators to prevent no-reflow in diabetic STEMI with high thrombus burden. A

Mohamed Hamza1, Islam Y Elgendy2

  • 1Cardiology Department, Ain Shams University, Cairo, Egypt.

Revista Espanola De Cardiologia (English Ed.)
|January 18, 2022
PubMed

Insights

Intracoronary eptifibatide plus vasodilators significantly reduced no-reflow in diabetic STEMI patients with high thrombus burden compared to aspiration alone. This treatment improved myocardial reperfusion and ejection fraction, though major adverse events were similar at six months.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Myocardial Infarction Management

Background:

  • Acute ST-elevation myocardial infarction (STEMI) in diabetic patients with high thrombus burden presents a significant challenge.
  • The no-reflow phenomenon is a major complication, leading to poorer outcomes.
  • Optimizing reperfusion strategies is crucial for improving patient prognosis.

Purpose of the Study:

  • To evaluate the efficacy of intracoronary eptifibatide plus vasodilators delivered via a thrombus aspiration catheter versus thrombus aspiration alone.
  • To determine the impact of this combined approach on reducing no-reflow risk in diabetic STEMI patients with high thrombus burden.

Main Methods:

  • A randomized study of 413 diabetic STEMI patients with high thrombus burden.
  • Intervention group received intracoronary eptifibatide, nitroglycerin, and verapamil post-aspiration.
  • Control group received thrombus aspiration alone.
  • Primary endpoints included myocardial blush grade and corrected Thrombolysis in Myocardial Infarction (cTFC).

Main Results:

  • The eptifibatide and vasodilators group showed significantly higher rates of myocardial blush grade-3 (82.1% vs 31.4%, P=.001).
  • This group also demonstrated improved reperfusion with lower cTFC (18.16 vs 29.64, P=.001) and better TIMI 3 flow (91.3% vs 61.65%, P=.001).
  • Ejection fraction improved at 6 months (55.2% vs 43%, P=.005), with no difference in major adverse cardiovascular events.

Conclusions:

  • Intracoronary eptifibatide plus vasodilators is beneficial in preventing no-reflow in diabetic STEMI patients with high thrombus burden.
  • The strategy enhances myocardial reperfusion and cardiac function.
  • Larger studies are recommended to confirm the impact on clinical outcomes.
Abstract

Keywords:
Glycoprotein IIb/IIIa receptor inhibitorInfarto de miocardio con elevación del STInhibidor del receptor de la glucoproteína IIb/IIIaIntervencionismo coronario percutáneoNo reflujoNo-reflowPrimary percutaneous coronary interventionST-elevation myocardial infarctionThrombus aspirationTromboaspiración

More Related Videos

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction05:26

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

Published on: May 28, 2019

9.4K
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

25.7K

Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
45
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
58
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
40
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
46
Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
108
Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
208