Efficacy of different application routes of tirofiban in elderly patients with STEMI after emergency

MA Xin; YU Fu-sheng; SU Yi

doi:10.3969/j.issn.1674-4055.2017.03.08

Abstract：Objective To compare the efficacy of intracoronary injection of tirofiban and intravenous tirofiban in the treatment of elderly patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).Methods 85 hospitalized STEMI patients from January 2015 to January 2016 were randomly divided into intracoronary group and intravenous group. Both groups were received 5μg/kg tirofiban intravenously after being diagnosed as STEMI. The intravenous group were then received PCI, and intracoronary group were given 5μg/kg tirofiban again after forward flow recovered then received PCI. Thrombolysis in Myocardial Infarction (TIMI) grade flow, TIMI myocardial perfusion grade (TMPG), the corrected TIMI frame count (CTFC) and the rate of major adverse cardiac events (MACE) were compared between two groups to analyze the clinical value of different routes of administration of tirofiban.Results After PCI, the difference of MACE between the two groups was statistically significant (6.7%vs. 22.5%,P<0.05). TMPG-3 (95.6%) was significantly higher in the intracoronary group than in the intravenous group (82.5%) and TMPG-2 (4.4%) was significantly lower than that in the intravenous group (17.5%), the difference was statistically significantP<0.05). There was significant difference between TIMI 3 flow (86.7%vs. 67.5%) and TIMI 2 flow (13.3%vs. 30.0%) in the two groups (P<0.05). At 2 hours after PCI, the rate of complete fall (CR) was significantly higher than that of the intravenous group (P<0.05), but the rate of partial fall (PR) and the rate of fall (NR) were significantly lower than those in the intravenous group (P<0.05). The difference of CTFC between the two groups was statistically significant (P<0.05).Conclusion Tirofiban administration by coronary injection is superior to elderly STEMI patients received PCI, which can effectively improve the patient's condition and reduce the incidence of adverse cardiac events.