Effect of tirofiban on heart rate variability and malignant arrhythmia incidence after emergency percutaneous coronary intervention for acute myocardial infarction
Liu Peng
Li Guyue
Abstract：Objective To explore the effect of tirofiban on heart rate variability (HRV) and malignant arrhythmia(MVA) incidence in patients with acute myocardial infarction (AMI) after emergency percutaneous coronary interention(PCI).Methods From September 2015 to August 2016,125 patients with AMI who had PCI were enrolled as observation group and 100 patients were enrolled as control group in the First Hospital of China Medical University.The control group had routine medication before PCI;the observation group had tirofiban (10 μg/kg) intravenously injected(3 min) before PCI and continuously administered[0.15 μg/(kg · min)] for 36 h.HRV indexes [time domain indexes:standard diviation of NN intervals (SDNN),standard diviation of average 5 min NN intervals (SDANN),root mean square of successive differences (rMSSD),percentage of NN intervals ＞ 50 ms different from preceding interval (PNN50);frequency domain indexes:low frequency power (LFP),high frequency power(HFP),LFP/HFP] and incidence of MVA were analyzed 48 h and 30 d after operation.Results There were significant differences of SDNN,SDANN,rMSSD and PNN50 30 d and 48 h after operation in both groups [control group:(84 ± 6) ms vs (58 ± 6) ms,(88 ± 4) ms vs (72 ± 5) ms,(49.7 ± 2.6) ms vs (28.1 ± 2.0) ms,(7.8 ± 1.7) ms vs (6.1 ± 0.6) ms;observation group:(96 ± 7) ms vs (67 ± 6) ms,(102 ± 6) ms vs (80 ±4) ms,(56.3 ± 1.8)ms vs (35.2 ±2.2)ms,(12.6 ±2.1)ms vs (9.8 ±0.8)ms] (P ＜0.05).There were significant differences of LFP,HFP and LFP/HFP 30 d and 48 h after operation in both groups[control group:(327 ±47)ms2 vs (197 ±31)ms2,(252 ±20)ms2 vs (107 ±5)ms2,(1.71 ±0.27) vs (1.99 ±0.41);observation group:(556 ±56)ms2 vs (233 ±36)ms2,(412 ±42)ms2 vs (169 ±6)ms2,(1.47 ±0.15) vs (2.51 ±0.51)](P ＜ 0.05).Differences of SDNN,SDANN,rMSSD,PNN50,LFP,HFP and LFP/HFP between groups were also significant(P ＜ 0.05).The incidence of MVA in observation group was significantly lower than that in control group[5.6％ (7/125) vs 20.0％ (20/100)] (P ＜ 0.05).Conclusion Preoperative use of tirofiban can effectively reduce postoperative HRV and MVA in AMI patients with PCI.
Keywords：Acute myocardial infarctionTirofibanPercutaneous coronary interventionHeart rate variabilityMalignant arrhythmia
Publication Date：2017-05-30
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：4( 691-694 )