Efficacy and safety of intra-coronary bolus injection of tirofiban during primary percutaneous coronary intervention for patients with acute ST-segment elevation myocardial infarction
10.3969/j.issn.1004-8812.2014.08.002
- VernacularTitle:急性ST段抬高心肌梗死患者急诊介入治疗单纯冠状动脉内注射替罗非班的疗效及安全性
- Author:
Qi ZHANG
;
Ruiyan ZHANG
;
Jian HU
;
Zhenkun YANG
;
Jiansheng ZHANG
;
Fenghua DING
;
Tianqi ZHU
;
Zhengbing ZHU
;
Xian ZHANG
;
Yilin HUANG
;
Weifeng SHEN
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Angioplasty;
Stent;
Tirofiban;
Prognosis
- From:
Chinese Journal of Interventional Cardiology
2014;(8):483-487
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyse and compare the effects and safety of early use (in emergency room, intravenous loading followed by infusion) with bolus injection during primary PCI of tirofiban, on post-procedural TIMI flow and 30d clinical outcomes. Methods Seven hundred and seven patients with acute STEMI treated by primary PCI in Ruijin hospital were retrospectively and enrolled screened. Among them, 86 patients with single bolus intra-coronary injection of tirofiban (25 μg/kg) during the procedure were served as observation group. Baseline, angiographic, PCI features and rate of major adverse cardiac events (MACE) at 30 d follow-up were compared with those received early intravenous infusion of tirofiban (10ug/kg bolus followed by 0.15μg/(kg·min) intravenous infusion)(control group, n=239). Results Compared with control group, patients in observation group were older[(63.8±11.4) vs. (57.9±8.8), P=0.01], had higher prevalence of hypertension (58.6%vs. 51.0%, P=0.005), multivessel disease (57.0%vs. 34.3%, P<0.001), and female in gender (40.7%vs. 25.1%, P=0.006). Post-procedural TIMI flow in culprit vessel and TMP grade were comparable between the two groups (P=0.66 and P=0.48, respectively). Reduction in TIMI minimal bleeding events were found in the observation group (2.3%vs. 9.6%, P=0.03). MACE free survival rate at 30d clinical follow-up was similar between the two groups (P=0.48). Conclusions Single bolus intra-coronary injection of tirofiban exerts similar effects in post-procedural TIMI flow, TMP grade in culprit vessel and 30d clinical outcomes compared with early use in emergency room with intra-venous loading and infusion, nevertheless, intra-coronary injection resulted in significantly reduced TIMI minimal bleeding events. Prospective, randomized clinical study is mandatory to prove our current results.
