Application of intracoronary injection of tirofiban through aspiration catheter during emergency intervention for ST-segment elevation myocardial infarction
Meng Xiangru
Wang Hongwei
Jin Yan
Lv Ping
Abstract：Objective To investigate the curative effect of tirofiban injection at site of coronary artery lesion through thrombus aspiration catheter during percutaneous coronary intervention (PCI) for treating acute ST-segment elevation myocardial infarction (STEMI). Methods STEMI patients (n=138) planed to receive PCI were chosen from the Zhuozhou Municipal Hospital of Baoding City of Hebei Province from Mar. 2014 to Mar. 2016. All patients were randomly divided into tirofiban group Ⅰ (thrombus aspiration+tirofiban injection through aspiration catheter+PCI), tirofiban group Ⅱ (thrombus aspiration+tirofiban injection through guiding catheter+PCI), and control group (thrombus aspiration+PCI, each n=46). The recovery of blood flow and improvement of heart function indexes were analyzed in 3 groups after treatments. Results The results of coronary angiography showed that the percentage of patients with TMPG grade 3 was higher in tirofiban group I than that in control group, percentage of patients with no-reflow was lower in tirofiban group than that in tirofiban group Ⅱ and control group, and percentage of patients with slow-reflow was lower in tirofiban group Ⅰ than that in control group (all P<0.05). The recovery of blood flow was better in tirofiban group than that in tirofiban group Ⅱ and control group. The percentage of patients with ST-segment reduction index>50% was higher in tirofiban group Ⅰ than that in control group, peak time of creatine kinase-MB isoenzyme (CK-MB) was advanced in tirofiban group Ⅰ compared with tirofiban group Ⅱ and control group, and peak time of cardiac troponin Ⅰ (cTnI) was advanced in tirofiban group Ⅰ compared with control group (all P<0.05). After PCI for 7 d, left ventricular ejection fraction (LVEF) was higher in tirofiban group Ⅰ than that in control group, and left ventricular end-diastolic inner diameter (LVEDD) was lower in tirofiban group Ⅰ than that in tirofiban group Ⅱand control group (all P<0.05). After PCI for 1 month, the incidence of major adverse cardiovascular events (MACE) was lower in tirofiban group Ⅰ than that in tirofiban group Ⅱ and control group (P<0.05). Conclusion The thrombus aspiration combining tirofiban injection at site of coronary artery lesion through thrombus aspiration catheter during PCI can effectively recover coronary flow, reduce no-reflow and slow-reflow, improve myocardial perfusion and heart function, decrease MACE incidence, and meliorate prognosis in STEMI patients.
Keywords：Acute ST-segment elevation myocardial infarctionPercutaneous coronary interventionThrombus aspirationTirofiban
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( 1338-1341 )