Role of Colchicine in Reduction of No Reflow Phenomenon in Patients with Acute ST-Segment Myocardial Infarction, Undergoing Primary Percutaneous Coronary Intervention
Nardine Sadek, Khalid Karem, Viola William, Ahmed Abd Elrahman- General Medicine
Abstract
Aim and objectives
The aim of this work is to study the efficacy of colchicine administration as a preventive tool for No Reflow in patients with STEMI undergoing primary PCI.
Patients and Methods
The study included 100 patients who presented with acute STEMI to the cardiology department of Ain Shams university hospitals and underwent primary PCI (percutaneous coronary intervention). They were divided into two groups where the first group received colchicine (1 mg) besides guideline recommended therapy before primary PCI and the 2nd group served as a control group and received guideline recommended therapy. Post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded.
Results
The majority of patients in both groups had the LAD as the culprit vessel for their presentation(63%). In the control group there were 19 patients with TIMI flow less than 3 and 20 patients with MBG less than 3. Meanwhile in the cases group there was 8 patients with TIMI flow less than 3 and 7 patients with MBG less than 3. This difference was statistically significant with a P value of 0.013. There were 40 patients in the cases group who received loading clopidogrel (600 mg) as premedications before Primary PCI (80%) vs 25 patients (50%) in the control group which was statistically highly significant with a P value of 0.002. In addition, Intracoronary medications (adrenaline, verapamil, tirofiban that where given during the procedure) used in 2 patients from the cases group vs 10 from the control group which was statistically significant with a P value of 0.014. There was not a statistically significant difference between the two groups regarding presenting balloon dilatation. Whereas, Post stenting balloon dilatation showed a statistically significant relationship of P value 0.014 which was done in 2 patients from the cases group vs 10 patients from the control group.
Conclusion
Colchicine loading before primary PCI resulted in improved postprocedural TIMI flow, MBG.