Impacto dos meios de contraste iodixanol e ioxaglato na reperfusão miocárdica em pacientes submetidos a angioplastia primária no infarto agudo do miocárdio

BACKGROUND: Despite the excellent performance and safety of primary angioplasty in reestablishing normal epicardial blood flow (TIMI flow, grade 3), a significant proportion of these patients with acute myocardial infarction (AMI) have damage in the microvascular integrity and impaired myocardial perfusion. It is possible that the contrast media used during the procedure interferes in myocardial perfusion by altering cell mechanisms involved in this process. Our objective was to compare contrast media iodixanol (nonionic isosmolar) and ioxaglate (ionic, low osmolality) in myocardial tissue perfusion in patients with AMI submitted to primary percutaneous coronary intervention (primary PCI). METHODS: A randomized study with a population of 201 patients with AMI with a pain-door time 40 frames and the secondary end point was the composition of cardiac death, reinfarction and stroke during hospitalization. RESULTS: CTFC > 40 frames after primary PCI occurred in 22.9% of patients in the ioxaglate group and 19.8% in the iodixanol group (p = 0.611). The secondary end point occurred in 9.5% of patients in the ioxaglate group and 9.4% in the iodixanol group (p > 0.99). CONCLUSION: The current study did not demonstrate significant differences in the no-reflow incidence between the contrast media ioxaglate and iodixanol in patients with AMI submitted to primary PCI. Also significant differences were not observed in the incidence of the combined clinical outcomes of death, reinfarction or stroke.