Impact of intracoronary eptifibatide on the right ventricular function in patients with acute inferior myocardial infarction

Background and aim Distal embolization during primary percutaneous coronary intervention of the proximal right coronary artery (RCA) leads to impairment of flow of right ventricular (RV) branches and RV dysfunction. Glycoprotein IIb/IIIa receptor antagonists improve microcirculation and decrease the incidence of distal embolization. In the present study we aimed to assess RV function in patients with acute inferior ST-segment elevation myocardial infarction who received intracoronary (i.c.) bolus eptifibatide, and to compare them with patients who received a standard intravenous (i.v.) dose. Patients and methods Sixty-six patients with acute inferior myocardial infarction who underwent primary percutaneous coronary intervention and whose culprit lesion was RCA proximal to major RV branch were included in the present study. Patients were divided into two groups. In the first group, 36 patients received double bolus intracoronary eptifibatide followed by i.v. infusion. In the second group, 30 patients received standard i.v. dose. Forty-eight hours after the index procedure, all the patients underwent standard echocardiography assessment of RV function using conventional two-dimensional and tissue Doppler imaging. Results There were no significant differences regarding baseline characteristics, final Thrombolysis In Myocardial Infarction (TIMI) flow, and left ventricular systolic function between the two groups. RV function indices, including tricuspid annular plane systolic excursion, myocardial performance index-tissue Doppler imaging, and RV fractional area change, were significantly better in patients who received i.c. bolus eptifibatide (P Conclusion I.c. double bolus eptifibatide followed by i.v. infusion was found to be superior to the standard i.v. dose with respect to RV function in patients with acute inferior ST-segment elevation myocardial infarction due to proximal RCA occlusion.