Effect of tirofiban route and timing on intraoperative no - reflow in patients with acute myocardial infarction
LIU Ji-wen
TANG Zeng-yao
WANG Xin-wang
LIU Yu-lian
ZENG Zi-wei
ZHU Bao-cheng
QIAO Ling-wei
Abstract：Objective To explore the effects of tirofiban administrated at different routes and timing on no-reflow in patients with acute myocardial infarction.Method 110 AMI patients were divided into group A and group B (including B1 and B2) according to the different ways of administration. Group A (n=32) received intravenous tirofiban in the emergency department, group B was treated with tirofiban by intracoronary administration. Among them, group B1 (n=38) was injected via guide catheter before the vessel was opened. Patients in group B2 (n=40) were given tirofiban via microcatheterization after balloon dilatation or PCI when no reflow occurred. Among the group A and B1, tirofiban could be re-injected when there was no flow after balloon expansion or PCI. TIMI flow grade and corrected TIMI blood flow count (CTFC), intraoperative tirofiban dosage, hospital adverse cardiac events (MACE), and postoperative bleeding were compared before and after target vessel stenting and stent implantation. Results TIMI blood flow grade and CTFC were superior to group B2 (P<0.05) in group A and group B1 before the target vessel is opened, and there was no statistically significant difference between A and B1 groups (P>0.05). The blood flow of TIMI in group A and group B1 was better than that in group B2 after the target vessel is opened (P<0.05), and B1 group was better to group A (P<0.05). TIMI blood flow grade and CTFC of target vessel in group B2 were better than that of group A and group B1 after Immediately stent implantation (P<0.05), and there was no significant difference between A and B1 groups (P>0.05). In group B2, the dosage of tirofiban was significantly less than that of group A and group B1 (P<0.05), and B1 group was less than that of group A (P<0.05). The incidence of postoperative bleeding in group B2 was the lowest, which was significantly lower than that in group A (P<0.05), and there was no significant difference compared with group B1 (P>0.05).Conclusion There have different effects on the blood perfusion of patients with AMI when treated with tirofiban on different routes and timing. In the emergency room intravenous tirofiban can improve coronary blood flow status earlier. Intracoronary injection of tirofiban during the PCI operation, especially after the opening of the occluded blood vessels, can more improved the blood perfusion with lower doses and less postoperative bleeding.
Keywords：TirofibanNo-reflowAcute myocardial infarctionPercutaneous coronary intervention
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 556-558,562 )