Observation on the effect of sodium nitroprusside combined with epinephrine for the treatment of acute myocardial infarction patients with no-reflow phenomenon during percutaneous coronary intervention

Objective To investigate the clinical effect of sodium nitroprusside combined with epinephrine on no-reflow and prognosis in patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary intervention (PCI). Methods A total of 58 acute ST elevation myocardial infarction patients, who suffered from no-reflow during PCI in our department from Jan 2016 to Jun 2017, were selected. Patients were randomly divided into treatment group (28 cases, intravenous injection of sodium nitroprusside combined with epinephrine when no reflow occurred) and control group (30 cases, intravenous injection of sodium nitroprusside when no reflow occurred). The angiographic results including thrombolyses in myocardial infarction (TIMI) and corrected TIMI frame count (CTFC) was assessed. The blood pressure, heart rate and arrhythmia during PCI were recorded. The incidence of adverse cardiovascular events in the two groups during hospitalization was compared between the two groups. Results Five minutes after no-reflow, the treatment group had a higher rank of TIMI and lower value of CTFC (P<0.05). The occurrence of sinus bradycardia and hypotension in the control group was significantly higher than that in the treatment group (P<0.05). The incidence of adverse cardiovascular events in the treatment group was lower than that in the control group during hospitalization (14.3% vs. 40.0%, P=0.028). Conclusions Intracoronary injection of sodium nitroprusside combined with epinephrine can effectively alleviate the no reflow phenomenon and reduce the incidence of adverse cardiovascular events during hospitalization. Key words: Acute myocardial infarction; No-reflow Phenomenon; Sodium nitroprusside; Epinephrine