Effect of post stenting Intracoronary Verapamil on Coronary Microcirculation in Primary PCI

Background: Primary percutaneous coronary intervention (PCI), also known as primary angioplasty, is considered to be the standard of care for cases with ST-segment elevation myocardial infarction (STEMI). Verapamil enhances microvascular circulation and reduces the no reflow phenomena. Aim of the Work: To assess the impact of IC verapamil on coronary microcirculation following implantation of stent in infraction related vessels during primary PCI. Patients and Methods: Sixty patients (Pts) with STEMI were given verapamil 100 -300 microgram intracoronary (IC) following primary PCI to the culprit vessel. the following parameters were compared before and after giving verapamil IC: TIMI flow grads (TFGs) 0-3, TIMI myocardial perfusion grade (TMPG) 0-3 and corrected TIMI frame count (cTFC) which measures the numbers of cine frames necessary to fill the culprit vessel. Results: The mean age of the 60 pts was 54.7 ± 10.6 years, 44 (73.3 %) were males. TFG, TMPG and cTFC were significantly better following verapamil than before its administration IC (p < 0.001, P< 0.003, and P < 0.001, respectively). Bradycardia was observed in 3.3% of pts. Our patients did not have any cases of cardiac failure. or died before hospital discharge. Conclusion: Verapamil administration after PCI had a statistically significant positive influence on coronary blood flow & myocardial perfusion.