Percutaneous Coronary Intervention Clinical Trial
Official title:
Impact of intRacoronary adrEnaline on Myocardial reperfuSion in STEMI paTients With Persistent Impaired cORonary Flow After pErcutaneous Coronary Intervention: the RESTORE-SIRIO Randomized Controlled Trial
Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy for
treating acute ST-segment elevation myocardial infarction (STEMI). The main goals are to
restore epicardial infarct-related artery patency and to achieve microvascular reperfusion
as early as possible. No-reflow is the term used to describe inadequate myocardial perfusion
of a given coronary segment without angiographic evidence of persistent mechanical
obstruction of epicardial vessels and it refers to the high resistance of microvascular
blood flow encountered during opening of the infarct-related coronary artery.
Despite optimal evidence-based PPCI, myocardial no-reflow can still occur, negating many of
the benefits of restoring culprit vessel patency, and is associated with a worse in-hospital
and long-term prognosis. Several strategies have been tested to revert the no-reflow
including the use of thrombectomy, glycoprotein IIb/IIIa inhibitors and the use of
intracoronary adenosine, but none has been demonstrated to effectively counteract the
phenomenon.
The trial aims to show the effect of the administration of intracoronary adrenalin on
myocardial reperfusion assessed by magnetic resonance in patients with STEMI undergoing PCI
and with persistent coronary angiographic The Thrombolysis in Myocardial Infarction (TIMI)
0-1 flow during the interventional procedure after failure of standard therapy.
n/a
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label
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