Gehani Abdurrazzak, Al-Suwaidi Jassim, Yacoub Magdi
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
Qatar Cardiovascular Research Center, Doha, Qatar.
Glob Cardiol Sci Pract. 2014 Oct 16;2014(3):228-31. doi: 10.5339/gcsp.2014.35. eCollection 2014.
The NAIMI trial has recently been published. It assessed one of the most contemporary and challenging issues in the management of acute myocardial infarction (AMI), namely prevention of reperfusion injury (RPI) after primary PCI for ST-elevation myocardial infarction (STEMI). It investigated the effect of the intravenous administration of Na nitrite given immediately prior to primary PCI for STEMI in 229 patients (118 in the treatment group, and 111 in placebo). The myocardial infarction (MI) size did not differ between the two groups as observed by cardiac MRI (CMR) with gadolinium enhancement at 6-8 days or plasma Troponin-I and creatine kinase (CK), or by left ventricular (LV) volume and ejection fraction (EF) as measured by echocardiography at 6-8 days and again at 6 months. They concluded that IV nitrites did not reduce the infarct size. There was, however, a trend towards benefit in diabetic patients in the post-hoc analysis. The small number of these subjects has probably lead to inconclusive outcome in this subset.
NAIMI试验最近已发表。该试验评估了急性心肌梗死（AMI）管理中最具时代性和挑战性的问题之一，即ST段抬高型心肌梗死（STEMI）患者直接经皮冠状动脉介入治疗（PCI）后再灌注损伤（RPI）的预防。该试验调查了229例STEMI患者在直接PCI前即刻静脉注射亚硝酸钠的效果（治疗组118例，安慰剂组111例）。通过钆增强心脏磁共振成像（CMR）在6 - 8天时观察，或通过血浆肌钙蛋白I和肌酸激酶（CK）观察，以及通过超声心动图在6 - 8天时和6个月时测量左心室（LV）容积和射血分数（EF），两组之间的心肌梗死（MI）大小无差异。他们得出结论，静脉注射亚硝酸盐不能减小梗死面积。然而，在事后分析中，糖尿病患者有获益的趋势。这些受试者数量较少，可能导致该亚组的结果尚无定论。
