Impact of intravenous administration of anisodamine on coronary microvascular dysfunction in patients with obstructive epicardial coronary artery disease after percutaneous coronary intervention

Purpose: To analyze intravenous administration of anisodamine's impact on coronary microvascular dysfunction (CMD) in obstructive epicardial coronary artery disease (CAD) patients who had undergone percutaneous coronary intervention (PCI). Methods: Enrollment of 210 patients in Shanghai Chest Hospital, Shanghai Jiaotong University with CMD was done in a randomized-controlled study. They were divided randomly into groups, viz, anisodamine (A) group and nitrate (N) group. A 14-day course of treatment was carried out in each group. 99mTc-MIBI myocardial perfusion imaging (MPI), treadmill exercise test (TET) and two-dimensional echocardiography (TDE) were performed, and the symptoms of angina pectoris were recorded before and after treatment according to the classification, frequency, and duration of angina, as defined by Canadian Cardiovascular Society (CCS). Results: After treatment, summed stress score (SSS) and summed rest score (SRS) of MPI in group A significantly decreased after treatment (p < 0.001, respectively) and were remarkably lower than those in group N (p < 0.001, respectively). The CCS class in group A improved after treatment (p < 0.001) and was also better than in group N (p < 0.001). The frequency and duration of angina attack in group A significantly reduced after treatment (p < 0.001, respectively) and were notably lower than in group N (p < 0.001, respectively). Left ventricular ejection fraction in group A after treatment was higher than that before treatment (p = 0.046) and than that in group N (p = 0.048). Furthermore, the side effects of anisodamine were slight and tolerable. Conclusion: Intravenous administration of anisodamine is a potentially suitable optional treatment for CMD in patients with obstructive epicardial CAD who have undergone PCI.