Key result
Planned EPIVER trial will evaluate intracoronary epinephrine and verapamil for refractory no-reflow in STEMI.
Why the study?
Refractory no-reflow during PCI worsens prognosis, and the efficacy of intracoronary epinephrine, verapamil, or their combination compared with standard treatment required evaluation.
Does intracoronary epinephrine, verapamil, or their combination improve epicardial blood flow and myocardial perfusion in patients with STEMI and refractory no-reflow during PCI?
RCT
Randomized into 4 groups
Does intracoronary epinephrine, verapamil, or their combination improve epicardial blood flow and myocardial perfusion in patients with STEMI and refractory no-reflow during PCI?
The EPIVER study protocol outlines a randomized trial to evaluate the efficacy of intracoronary epinephrine, verapamil, or their combination for managing refractory no-reflow in STEMI patients undergoing PCI.
No takes yet. Share an insight, caveat, or question.
May support intracoronary epinephrine/verapamil for refractory no-reflow; hypothesis-generating and needs randomized confirmation before practice change.
Dil et al. (2022) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) and refractory no-reflow. Intracoronary epinephrine and verapamil vs. Standard therapy, intracoronary adrenaline alone, or intracoronary verapamil alone was evaluated on Epicardial blood flow (TIMI and MBG scales), peak troponin levels, ST segment changes, echocardiography, MRI, and SPECT. The EPIVER study is a planned randomized trial to evaluate intracoronary epinephrine and verapamil for refractory no-reflow in STEMI; clinical results are not yet available.
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