Curative effect and safety of early administration of tirofiban in patients with emergency coronary ;intervention

CHAI Xiao-hong; YANG Fan; YAN Rui; WANG Jing-ping

doi:10.3969/j.1674-4055.2015.03.36

Abstract：Objective To investigate the clinical efficacy and safety of tirofiban administrated before emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods STEMI patients with PCI (n=134) were chosen from Jan. 2012 to Dec. 2013, and randomly divided into observation group (n=69) and control group (n=65). The outcomes of coronary angiography (CAG), TIMI flow, sumSTR of electrocardiogram (ECG), incidence of major adverse cardiovascular events (MACE) within 1 w after hospitalization and 90 d after PCI, LVEF, platelet count (PLT) and incidence bleeding events before and 24 h and 1 w after PCI were compared between 2 groups. Results The difference in general clinical data and CAG outcomes had no statistical significance (all P>0.05) between 2 groups. The proportion of patients with grade III TIMI flow after PCI was higher in observation group than that in control group (97.1%vs. 92.3%, P>0.05), while proportion of patients with sumSTR>50%after PCI for 90 min was significantly higher in observation group than that in control group (94.2%vs. 80.0%, P<0.05). The incidence of refractory angina pectoris and MACE decreased significantly in observation group compared with control group (2.9%vs. 13.8%, 4.3%vs. 15.4%, all P<0.05) within 1 w after hospitalization. The incidence of MACE had no significant changes after PCI for 90 d (1.4%vs. 3.1%), and LVEF [(53.86±4.50)%vs. (52.03±4.10)%] increased significantly in observation group compared with control group (P<0.05). PLT and incidence bleeding events before and 24 h and 1 w after PCI had no statistical difference between 2 groups (all P>0.05). Conclusion Early administration of tirofiban can significantly promote the perfusion of myocardial cells and microcirculation, and improve left cardiac function and clinical prognosis without increasing bleeding risks.