Untersuchung des Einflusses des Thrombozytenaggregationshemmers Abciximab auf die transiente rotablationsinduzierte Hypoperfusion mittels Single-Photonen-Emissions-Tomographie
This study evaluated the effect of the glycoprotein IIb/IIIa (GPIIb/IIIa) antagonist abciximab on myocardial hypoperfusion during percutaneous transluminal athercetomy (PTRA). Therefore 70 consecutive patients with complex lesions were studied using resting Tc-99m sestamibi single-photon emission computed tomography prior, during and 2 days after the procedure. The last 25 patients received periprocedural abciximab (group A) compairing their results to the remaining 45 patients (group B). The left ventricle was divided into 24 regions for semiquantitative analysis myocardial perfusion was expressed as percentageof maximal sestamibi uptake. Baseline characteristics did not differ between the groups. Transient perfusion defects were observed in 37/45 (82%) patients of group B, but only in 8/25 (32%) patients of group A (p<0.001). Perfusion was significantly reduced during PTRA in 3± 2.3 regions in group B compared to 1.5± 2.4 regions in group A (p<0.01). Perfusion in the region with maximal reduction during PTRA in group B and A was 80% ± 11% and 77 ± 14% at baseline, decreased to 56 ± 16% (p<0.001) and 67 ± 14% respectively during PTRA, and normalized to 79 ± 13% in both groups after PTRA. In group B 9 patients (20%) had mild creatine kinase and/or troponin t elevations compared to 2 patients (8%) in group A. These data indicate that GPIIb/IIIa blockade reduces incidence, extent and severity of transient hypoperfusion during PTRA. Thus, platelet aggregation may be of importance to the development of transient PTRA-induced myocardial hypoperfusionand its clinical consequences such as the risk of non-Q-wave infarction.
info:eu-repo/classification/ddc/610, Medizin
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