The incidence of postoperative myocardial infarction and the left ventricular function in patients with type 2 diabetes mellitus after recanalization of chronic coronary occlusions].

I V Petrenko, O A Petrenko, M A Popova, S I Mamedova, I A Urvantseva

Terapevticheskiĭ arkhiv 2012

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To study the effects of intracoronary administration of the ischemic preconditioning (IP) trigger adenosine on the reduced incidence of percutaneous coronary intervention (PCI)-associated myocardial infarction (MI) and left ventricular (LV) systolic and contractile function in patients with type 2 diabetes mellitus (DM) during recanalization of chronic coronary occlusions (CCO). The patients were divided into 4 groups: 1) 45 patients without DM who received intracoronary placebo infusion; 2) 51 patients without DM who had 10 mg intracoronary adenosine during PCI; 3) 34 patients with type 2 DM who had intracoronary adenosine during PCI; 4) 37 with type 2 DM who received intracoronary placebo. Troponin I and the MB fraction of creatine phosphokinase were measured an hour before and 18-24 hours and 5 days after PCI. The authors estimated the incidence of PCI-associated MI according to the ESC/ACCF/AHA/WHF (2007) criteria and the time course of changes in LV ejection fraction (EF) and end-systolic volume (ESV) and end-diastolic volume, impaired LV local contractility index (ILVLCI) in 167 patients with CCO 1 day and 1 and 12 months after PCI. There was an improvement in myocardial systolic and contractile function after recanalization and stenting for CCO. The intracoronary adenosine groups showed significantly reduced incidence of PCI-associated MI, increased LV EF, and decreased LV ESV and ILVLCI as compared to the placebo groups. The intracoronary injection of the IP trigger adenosine is an effective and safe method to improve LV systolic and contractile function in patients with CCO and type 2 DM.

Citation

I V Petrenko, O A Petrenko, M A Popova, S I Mamedova, I A Urvantseva. The incidence of postoperative myocardial infarction and the left ventricular function in patients with type 2 diabetes mellitus after recanalization of chronic coronary occlusions]. Terapevticheskiĭ arkhiv. 2012;84(10):28-32