Objectives To evaluate the clinical efficacy and safety of verapamil injection for preventing slow-flow/no-reflow phenomenon after percutaneous coronary intervention.
Methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 2, 2012), PubMed, EMbase, China Biology Medicine disc and Google Scholar. Two reviewers independently evaluated the quality of included studies and extracted the data. Meta-analysis was performed by RevMan 5.0 software.
Results Seven randomized controlled trials (RCTs) involving 539 patients were included. The results of meta-analyses showed that intracoronary verapamil could reduce the incidence of no-reflow/ slow-flow and reduce Corrected TIMI Frame Count (CTFC) as well as TIMI myocardial perfusion grade (TMPG). In addition, verapamil could reduce 30-day wall motion index (WMI) after PCI,therefore improve myocardial ischaemia. For adverse reaction, verapamil could reduce the incidence of major adverse cardiac events (MACEs) in patients during hospitalization and 2-month after PCI
Conclusions Intracoronary verapamil is beneficial in preventing no-reflow/slow-flow, in reducing CTFC and TMPG, and in reducing wall motion index (WMI). It also likely reduces 2-month major adverse cardiac events (MACEs) in patients after percutaneous coronary intervention. However, we must caution that in this review there can be a moderate possibility of bias with regard to patient selection, performance and publication because of the small number of the included studies. Larger sample size, high—quality RCTs are needed for more reassuring analysis.