Perftoran therapy perspectives in reperfusion syndrome prevention among acute myocardial infarction patients
Abstract
In spite of recent achievements in Q-wave myocardial infarction (Q-IM) management, prevention of reperfusion syndrome, developing due to coronary artery opening in thrombolytic therapy (TLT), is still an unsolved problem. Aim. To assess the incidence of reperfusion syndrome and its manifestations, cardiac arrhythmias and recurrent pain syndrome attacks, in Q-IM patients treated with perftoran. Material and methods. In total, 166 Q-IM patients were examined and treated. All participants received TLT; 46 individuals also received perftoran. The incidence of cardiac arrhythmias and recurrent pain syndrome attacks was assessed. Results. In Q-IM patients, perftoran and TLT reduced reperfusion syndrome incidence by 26.8%, ventricular extrasystolia incidence – by 24.2%, and sinus bradycardia – by 17.3%; no ventricular fibrillation cases were registered. Moreover, perftoran decreased recurrent pain syndrome attack incidence. Conclusion. Perftoran beneficially influenced clinical course of reperfusion syndrome in Q-IM. Perftoran could be included into Q-IM complex therapy.
About the Authors
S. S. ShuvalovRussian Federation
V. Yu. Ushakov
Russian Federation
References
1. Воробьев С.И. Уменьшение деструктивного действия фосфолипазы А2 эмульсией перфторуглеродов на модели изолированного сердца. Перфторуглеродные активные среды для медицины и биологии. Пущино «ОНТИ РАН» 1993; 186-9.
2. Голиков А.П., Руднев Д.В. Реперфузионный синдром при тромболитической терапии инфаркта миокарда. Кардиология 1989; 11: 66-70.
3. Ладилов Ю.В. Изучение кардиопротекторных свойств эмульсии перфторуглеродов при острой ишемии миокарда. Автореф дисс канд биол наук. Москва 1991.
4. Максимов И.В. Диагностика, профилактика и лечение реперфузионного синдрома при остром инфаркте миокарда. Автореф дисс докт мед наук. Томск 2000.
5. Семиголовский Н.Ю., Оболенский С.В., Рыбкин М.П. и др. Сравнительная оценка эффективности 10 антигипоксических средств в остром периоде инфаркта миокарда. Международ мед обзоры 1994; 5: 334-8.
6. Симхович Б.З., Мерена Д.В., Хачи Х.Б. и др. Влияние нового структурного аналога гамма-бутиробетаина – 3=(2,2,2=триметилгидразоний) пропионата на содержание карнитина, карнитинзависимое окисление жирных кислот и некоторые показатели энергетического обмена в миокарде. Воп мед хим 1986; 4: 72-6.
7. Сыркин А.Л. Инфаркт миокарда. Москва «МИА» 1996.
8. Antman EM, Anbe DT, Armstrong PW, et al. ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction: executive summary: a report of the ACC/ AHA Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines on the Management of Patients With Acute Myocardial Infarction). JACC 2004; 44: 671-719.
9. Datta S, Das D, Engelman R, et al. Enhanced myocardial protection by Nicitinic Acid, an antilipolytic compound: mechanism of action. Basic Res Cardiol 1989; 84: 63-76.
10. Diaz R, Paolasso E, Piegas L, et al. Metabolic modulation of acute myocardial infarction: the ECLA Glucose Insulin Potassium Pilot Trial. Circulation 1998; 98: 2227-34.
11. The EMIP–FR GROUP. Effect of 48–h intravenous trimetazidine on short– and long–term outcomes of patients with acute myocardial infarction, with and without thtombolytic therapy. Eur Heart J 2000; 21: 1537-46.
12. Fath-Ordoubadi F, Beatt K. Glucose–Insulin–Potassium therapy for treatment of acute myocardial infarction: an overview of randomized placebo controlled trials. Circulation 1997; 96: 1152-6.
13. Steapoole PW. The pharmocology of dichloroacetate. Metabolism 1989; 38: 1124-44.
14. Teo K, Yusuf S, Furberg D, et al. Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction. JAMA 1993; 270: 1589-95.
15. Zehender M, Utzolino S, Furtwangler A, et al. Time course and interrelation of reperfusion-induced ST changes and ventricular arrhythmia’s in acute myocardial infarction. Am J Cardiol 1999; 68: 1138-42.
Review
For citations:
Shuvalov S.S., Ushakov V.Yu. Perftoran therapy perspectives in reperfusion syndrome prevention among acute myocardial infarction patients. Cardiovascular Therapy and Prevention. 2006;5(4):82-85. (In Russ.)