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Brain & Heart Atropine can reducing reperfusion vagal reflex in STEMI

Table 1. Baseline characteristics of the treatment group and the control group.
Variables Experimental group (n=70) Control group (n=72) P‑value
Age (years) 61.62±12.90 62.68±9.66 0.589
Male, n (%) 57 (81.4) 60 (83.3) 0.766
BMI (kg/m ) 24.0±3.1 23.6±2.9 0.805
2
Smoker, n (%) 48 (68.6) 43 (59.7) 0.272
Hypertension, n (%) 31 (44.3) 22 (30.6) 0.075
Diabetes mellitus, n (%) 18 (25.7) 14 (19.4) 0.371
Stoke, n (%) 1 (1.4) 5 (6.9) 0.209
LVEF (%) 58±6 57±7 0.912
Single branch lesion, n (%) 23 (32.9) 22 (30.6) 0.768
Right coronary atherosclerosis, n (%) 63 (90.0) 63 (87.5) 0.638
Proximal 8 (11.4) 12 (16.7) 0.370
Mid 17 (24.3) 30 (42.9) 0.069
Distal 11 (15.7) 12 (17.1) 0.878
Chest pain (min) 300 (180.00, 600.00) 300 (195.00, 433.50) 0.641
Door-to-balloon (min) 83.5 (52.75, 99.75) 70.5 (52.75, 101.75) 0.239
Occluded coronary artery, n (%)
Right coronary 63 (90%) 63 (87.5) 0.638
Left circumflex 7 (10%) 9 (12.5) 0.638
Potassium (mmol/L) 3.9±0.4 4.0±0.4 0.875
Creatinine (μmol/L) 67.3±16.0 68.4±17.1 0.712
QT interval (ms) 395.7±43.0 397.9±42.5 0.757
PR interval (ms) 169.6±22.9 170.3±21.5 0.847
ST elevation (mm) 1.9±1.2 1.8±1.4 0.812
β-blockers, n (%) 18 (25.7) 20 (27.8) 0.781
BMI: Body mass index; LVEF: Left ventricular ejection fraction

This may, in part, explain why the vagal reflex is evident in reduced the incidence of reperfusion vagal reflex-related
acute inferior myocardial infarction reperfusion [1,10,11] . events, such as bradycardia, hypotension, ventricular
tachycardia, and ventricular fibrillation, during emergency
Atropine is an anticholinergic drug with potent and
nonspecific anticholinergic activity. The common side PCI for inferior wall STEMI and improved the safety of
effects of atropine are parasympathetic stimulation, this procedure. High-dose (2 mg) atropine administration
has more advantage in terms of safety and effectiveness
including dry mouth and eyes, decreased sweating, than low-dose (0.5–1 mg) atropine treatment.
hyperthermia, headache, blurred vision, constipation,
urinary retention, tachycardia, palpitation, and anxiety . When the guidewire and balloon pass through the right
[12]
Atropine has a rapid onset of action and short half-life. It coronary artery or the circumflex branch during emergency
is commonly used in the emergency treatment of cardiac PCI, tissue cells are reperfused, and excessive calcium excites
arrhythmias, acute bronchospasm, and anticholinesterase the cardiac ganglion plexus, causing the quantum release
[15]
overdose or intoxication; prevention of vagal reflexes; of acetylcholine accumulated in a number of vesicles .
and reduction of secretions during anesthesia; currently, During this process, numerous muscarinic potassium (K )
Ach
it is also used in the treatment of myopia . Atropine channels are activated with potential for negative inotropic,
[13]
antagonizes the central nervous system and muscarinic negative frequency, and negative conduction effects on the
[16]
symptoms caused by stimulation of the postsynaptic heart . This causes vagal nerve excitation, as evidenced by
membrane through competitive inhibition of postsynaptic a slow heart rate and atrioventricular block.
acetylcholine receptors and direct vagolytic effects . In One of the main complications following emergency
[14]
this study, prophylactic intracoronary atropine significantly PCI for acute thrombotic occlusion of the right coronary

Volume 1 Issue 1 (2023) 4 https://doi.org/10.36922/bh.193