Angiotensin receptor blockers reduce no-reflow post-PCI

(HealthDay) -- For patients with acute myocardial infarction (AMI), pretreatment with angiotensin receptor blockers (ARBs) is linked with reduced incidence of the no-reflow phenomenon after percutaneous coronary intervention (PCI), according to a study published online April 10 in Cardiovascular Therapeutics.

To investigate the role of early ARB treatment in the development of no-reflow after infarction, Tau Hu, from Xijing Hospital in Xi'an, China, and colleagues followed 276 patients with AMI who underwent successful PCI. No-reflow was evaluated by the Thrombolysis in Myocardial Infarction (TIMI) frame count method using angiographic images collected after PCI and stenting, with a TIMI flow grade <3 indicative of no-reflow.

In the 51 patients receiving chronic ARB before admission, the researchers found a reduced incidence of no-reflow compared to those not receiving ARB treatment (8.7 versus 26.7 percent; P = 0.003). There was no significant difference in the incidence of the no-reflow phenomenon for patients with and without hypertension. ARB pretreatment, but not blood pressure, was a significant predictor of no-reflow.

"Chronic pretreatment of ARB is associated with the reduction of the no-reflow phenomenon in patients with reperfused AMI and could preserve microvascular integrity after AMI independent of blood pressure lowering, which may contribute to better functional recovery," the authors write.

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