Patients undergoing elective PCI (n = 70) were randomly assigned to the landiolol (n = 35) or control (n = 35) group. Landiolol or saline was administered into target vessels through a balloon catheter for 1 min before and after first balloon inflation followed by continuous intravenous administration for 6 h after PCI. The incidence of myocardial injury defined by cardiac troponin-I (cTnI) ¨R 0.05 ng/ml was 79 % of the patients in the control group compared to 56 % in the landiolol group (p = 0.04). The cTnI level at 24 h after PCI tended to be lower in the landiolol group (0.57 ¡À 1.14 versus 1.27 ¡À 2.48 ng/ml; p = 0.07), while the CK-MB level was not significantly different between the landiolol and control groups. The incidence of peri-procedural myocardial infarction defined by cTnI ¨R 0.12 ng/ml was significantly (p = 0.02) lower in the landiolol group (41 % ) compared to the control group (70 % ). There was no incidence of coronary spasm, hypotension, bradycardia or heart failure during and after PCI in the two groups.
Brief intracoronary followed by continuous intravenous administration of landiolol is safe and effective for myocardial protection in the face of elective PCI.