Long-term compound danshen dripping pills therapy reduces the no-reflow phenomenon in nondiabetes mellitus patients after primary percutaneous coronary intervention for acute myocardial infarction.

ABSTRACT

BACKGROUND: Cases with no-reflow increased significantly and accounted for about 5-50% of cases in primary percutaneous coronary intervention (PPCI) patients in recent years. It is important to identify patients at high risk of no-reflow. Ingredients of compound danshen dripping pills (CDDP), a popular Chinese traditional medicine, can alleviate myocardial ischemia, inhibit inflammation and angiotensin convert enzyme, and reduce cell apoptosis, among other effects. In this study, we aimed to assess whether long-term treatment with CDDP (>1 year, could reduce the no-reflow phenomenon in non-diabetes mellitus (DM) patients after PPCI for acute myocardial infarction (AMI). METHODS: We enrolled patients according to inclusion and exclusion criteria. Clinical and PPCI data were collected. Patients were divided into 2 groups according to history of CDDP therapy. Data of the CDDP group and non-CDDP group were compared. Single and multivariate analysis was used to find factors associated with no-reflow. RESULTS: Among these 399 patients, the no-reflow phenomenon occurred in 96 patients (24.1%). The results showed that patients with long-term CDDP treatment had lower incidence of no-reflow than those without CDDP treatment within 1 year (9/68 vs. 87/331, 13.2% vs. 26.3%, P=0.0219). Univariate and multivariate stepwise logistic regression analysis identified a few admission parameters associated with the no-reflow phenomenon prior myocardial infarction (MI) [odds ratio (OR) 3.13, 95% CI 1.42-4.89], systolic blood pressure (SBP) <100 mmHg (OR 1.78, 95% CI 1.28-4.06), cardiac troponin T (cTnT) (OR 1.78, 95% CI 1.28-4.06), high-sensitivity C-reactive protein (hs-CRP) (OR 1.08, 95% CI 1.01-1.15), brain natriuretic peptide (BNP) (OR 3.76, 95% CI 1.31-9.75), interleukin-6 (IL-6) (OR 1.42, 95% CI 1.17-3.29), ejection fraction (EF) (OR 1.39, 95% CI 1.09-3.28), left ventricular end-diastolic diameter (LVEDD) (OR 1.28, 95% CI 1.05-4.23), anterior wall infarction (OR 2.83, 95% CI 1.69-5.76), and long-term CDDP treatment (OR 0.44, 95% CI 0.89-0.21). CONCLUSIONS: Prior MI, SBP, cTnT, hs-CRP, BNP, and IL-6 on admission, along with EF, LVEDD, and anterior wall infarction are all predictors for no-reflow phenomenon. Long-term treatment with CDDP can reduce no-reflow phenomenon.