Effects of intracoronary diltiazem on certain hemostatic parameters during acute myocardial infarction in swine

Victor L. Serebruany, Matthew L. Schlossberg, Lisa R. Edenbaum, William R. Herzog, Paul A. Gurbel

Research output: Contribution to journalArticle

Abstract

Controversy currently exists regarding the use of diltiazem in the treatment of acute myocardial infarction (AMI), due to conflicting results from clinical trials and animal studies. The purpose of this project was to evaluate the changes in the hemostatic profile during AMI following low dose intracoronary diltiazem infusion. Fourteen Yorkshire swine underwent thoracotomy and 50 min LAD occlusion, followed by 3 h of reperfusion. The first group (n = 8) received 2.5 mg of diltiazem intracoronary at a rate of 5.6 μg kg min- 1 at the onset of reperfusion. The second group (n=6) received 0.9% saline intracoronary at the onset of reperfusion and served as the control. The dynamics of plasma antithrombin-III (AT-III), Protein C, total Protein S, fibronectin, endothelin-1 (ET-1), and the stable metabolites of thromboxane (TxB2) and prostacyclin (6-keto- PGF1a) were determined at baseline, then twice during occlusion and finally three times during reperfusion. Diltiazem infusion resulted in diminished ET-1 (34.5%), fibronectin (23.2%), and TxB2 (35.6%); and elevated Protein C (29.3%) when compared with controls. We conclude that intracoronary diltiazem favorably influences hemostasis during AMI in swine. The cardioprotective effects of diltiazem during AMI may be related to the improved hemostatic profile and the reduced incidence of thrombotic complications in such patients.

Original languageEnglish (US)
Pages (from-to)21-29
Number of pages9
JournalInternational Journal of Cardiology
Volume61
Issue number1
DOIs
StatePublished - Aug 29 1997

Keywords

  • Animal model
  • Diltiazem
  • Hemostasis
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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