cardiology-insights-2019-scientifictracks

7 / 11

Cardiology Insights 2019 Journal of Heart and Cardiovascular Research
ISSN: 2576-1455 Page 29
March 07-08, 2019
Berlin, Germany
New Horizons in Cardiology
& Cardiologists Education
22nd International Conference on
Novel technique to prevent no/slow flow during PCI by
sodium nitroprusside injection time, point and method
Sarbesh Kumar Jha
Koshi Zonal Hospital, Nepal
Introduction: The no-reflow incidence appears to be
highest in acute myocardial infarction patients who
undergoes primary percutaneous coronary intervention
(PCI) or during PCI of saphenous vein grafts. The
intracoronary administration of medications that causes
vasodilatation in small distal coronary vasculature
forms the base of management of no-reflow. Sodium
nitroprusside (NTP) does not require intracellular
metabolism to induce vasodilatation in microcirculation.
In view of above present study was undertaken to
evaluate efficacy and usefulness of sodiumnitroprusside
in prevention of no/ slow reflow at the time of fixing
stents and balloons simultaneously and complications
associated with it.
Material & Methods: The current study comprised of
93 patients who were done percutaneous coronary
interventions and were randomly divided into two groups
namely: Drug (Nitroprusside) given group (n=47) and
placebo group (n=46). A stent or a balloon on specific
lesion was passed and then loading dose of sodium
nitroprusside (50-100 micro gram) or normal saline (2-3
ml) was prepared and injected through guiding catheter
into coronary artery. Maximum Duration of decreased
BP and TIMI Grade were noted. A Pearson correlation
analysis was conducted to examine whether there is a
relationship between Nitroprusside and Coronary Slow/
No Reflow. A statistical analysis of numerical variables
expressed as mean±SD was done using ANOVA.
Results: Five cases of coronary slow/no reflow in
placebo group and no cases in nitroprusside group were
reported. A significant and negative relationship between
2 parameters (r=.24, N=93, p=.02). The Lowest SBP
was 56 mmHg (Mean=101.34, SD=20.663), maximum
SBP difference with in 2-3 minute each time drug was
given was 100 mmHg (Mean=29.38, SD=18.431) and
maximum duration of falling blood pressure was 180
seconds (Mean=91.21, SD=24.655).
Conclusion: Intracoronary nitroprusside is useful for the
prevention of the slow reflow or no-reflow phenomenon
following PCI in acute myocardial infarction. This
knowledge can be utilized to prevent the coronary vaso-
spasm during PCI which would be beneficial to reduce
complications during and after PCI. After this trial since
2013-2017 we used same procedure for more than 4000
patients and only two patients were reported slow flow.
Sarbesh Kumar Jha, J Heart Cardiovasc Res 2019, Volume 3
DOI: 10.21767/2576-1455-C1-002