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2015 ; 2015
(ä): 382086
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Short-Term Effects of Verapamil and Diltiazem in the Treatment of No Reflow
Phenomenon: A Meta-Analysis of Randomized Controlled Trials
#MMPMID26504804
Wang L
; Cheng Z
; Gu Y
; Peng D
Biomed Res Int
2015[]; 2015
(ä): 382086
PMID26504804
show ga
Currently, there is still a lack of an optimal treatment for no reflow phenomenon
(NRP). We analyzed the efficacy and safety of using nondihydropyridine calcium
channel antagonists (NDHP, verapamil/diltiazem) in patients suffering from NRP.
Eight RCTs with 494 participants were eligible for analysis. The pooling analysis
showed that intracoronary verapamil/diltiazem injection significantly decreased
the occurrence of the coronary NRP (RR: 0.3, 95% CI: 0.16-0.57; P = 0.0002) and
reduced corrected thrombolysis in myocardial infarction (TIMI) frame Count (WMD =
-9.24, 95% CI -13.91-4.57; P = 0.0001) in patients with NRP. Moreover,
verapamil/diltiazem treatment showed superiority in reducing wall motion index
(WMI) compared to the control at day 1 (WMD = 0.11, 95% CI: 0.02-0.20; P = 0.02)
(P < 0.05). There was also a significantly greater decline at occurrence of the
major adverse cardiac events between verapamil/diltiazem and control groups (WMD:
0.4, 95% CI: 0.19-0.84; P = 0.02). However, using verapamil/diltiazem did not
provide additional improvement of left ventricular ejection fraction post
procedure (at 7 days, WMD, 0.1; 95% CI, -2.43-2.63; P = 0.94; at 30 days, WMD,
0.42; 95% CI, -2.09-2.92; P = 0.75). NDHP use is beneficial in attenuating NRP
and reducing 6-month MACEs in patients with NRP.