Platelet glycoprotein IIb/IIIa receptor blockade and coronary resistance in unstable angina
Mario Marzilli, MD*,*,
Gianmario Sambuceti, MD ,
Roberto Testa, MD and
Silvio Fedele, MD
* University of Siena, Siena, Italy
Institute of Clinical Physiology CNR, Pisa, Italy
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Figure 1 The coronary flow reserve (CFR) (left) and fractional flow reserve (FFR) (right) responses to abciximab and percutaneous transluminal coronary angioplasty (PTCA). Abciximab improved CFR but not FFR, indicating a greater effect of the drug on coronary microvascular function than on stenosis severity. Data are shown as average values ± SEM. *p < 0.05 vs. baseline. °p < 0.01 vs. baseline and abciximab.
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Figure 2 Plots of coronary flow reserve (CFR) (y axis) and fractional flow reserve (FFR) (x axis) in all patients before treatment (left), during abciximab infusion (center), and after stenting (right). No correlation was observed between these two descriptors of stenosis severity. After stenting, the persistence of abnormal flow reserve was not caused by persistence of a pressure drop along the epicardial segment.
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Figure 3 Effect of abciximab on epicardial (left) and microvascular (right) coronary resistance. Data are shown as average values ± SEM before treatment (open circles connected by solid line), after abciximab (open squares connected by dashed line), and after stenting (solid triangles connected by dotted line). Abciximab limited the increase of epicardial resistance induced by hyperventilation and significantly reduced microvascular resistance in the jeopardized coronary vascular bed under all study conditions. *p < 0.05 vs. corresponding baseline. °p < 0.01 vs. corresponding condition without abciximab. p < 0.01 vs. corresponding condition after abciximab.
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