Effects of thrombus aspiration and tirofiban injection in infarct-related artery during PCI intervention for patients with ST-elevation acute myocardial infarction

DAI Zhi-yin; YAN Jin-chuan; WANG Zhong-qun; ZHU Jie

doi:10.3969/j.issn.1002-266X.2015.28.001

Abstract：Objective To observe the efficacy of thrombus aspiration and tirofiban injection in the infarct-related ar-tery (IRA) during primary percutaneous coronary intervention (PCI) for patients with ST-elevation acute myocardial infarc-tion ( STEMI) .Methods A total of 180 STEMI patients were randomly divided into three groups, 60 cases in each group:group A which received the IRA thrombus aspiration and tirofiban injection+PCI, group B which received IRA thrombus aspiration +PCI and group C treated with PCI.The color Doppler ultrasound examination was performed at 1 day and 1 year after PCI to observe the left ventricular end systolic volume index ( LVESVI) , left ventricular end diastolic vol-ume index ( LVEDVI) , left ventricular ejection fraction ( LVEF) and ventricular remodeling.Hemorrhage events in a week and the cardiovascular events in a year among three groups were compared.Results After 1-year follow-up of 175 cases, 1 case in the group A died of cardiac rupture on the fifth day after PCI;2 cases in the group B and 2 cases in the group C died of sudden cardiac death in one year after PCI.One year after operation, LVEDVI and LVESVI were decreased, LVEF was increased in the group A as compared with those of the group B and group C ( all P<0.05);the ventricular remode-ling was found in 4 cases (6.7%) of group A, 12 cases (20.6%) in the group B and 17 cases (29.3%) in the group C, and the remodeling rate of group A was lower than those of group B and group C ( all P<0.05);in the group A, angina re-currence occurred in 3 cases, cardiac insufficiency was found in 2 cases, sudden cardiac death was found in 1 case, and the incidence of adverse cardiovascular events was 10.1%, in the group B, they were 7, 5, 2 cases and 24.1%, respec-tively, 9, 8, 2 cases and 32.7%in the group C, respectively, and the incidence of adverse cardiovascular events of group A was lower than that of group B and group C (all P<0.05).One week after operation in the three groups, the mild bleeding was found in the skin, mucous membrane, puncture sites and gingiva, but no massive hemorrhage or severe bleed-ing occurred, and no significant difference was found in bleeding among these three groups (all P>0.05).Conclusion Thrombus aspiration and tirofiban injection in the IRA during PCI can reduce ventricular remodeling of STEMI patients, im-prove the cardiac function, reduce the occurrence of cardiovascular events and do not increase the risk of hemorrhage.