A reseach on large dosage of tilofiban injection into coronary artery in patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention
10.3969/j.issn.1008-9691.2015.02.018
- VernacularTitle:冠状动脉内注入大剂量替罗非班在急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗中的应用研究
- Author:
Haipeng CAI
;
Junying RUAN
;
Zujin LIN
;
Lei CHEN
;
Wei SONG
;
Yushun XU
;
Huili PAN
- Publication Type:Journal Article
- Keywords:
Coronary artery;
Large dosage of tilofiban;
ST-segment elevated myocardial infarction;
Primary percutaneous coronary intervention
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;26(2):181-184
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the effect and safety about large dosage of tilofiban injection into coronary artery in patients with ST-segment elevated myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A prospective study was conducted. Two hundred and eighteen patients with STEMI admitted into Cardiology Department of Taizhou Central Hospital were enrolled. According to the difference in dosage, they were divided into a large dosage tilofiban group (102 cases) and a routine dosage tilofiban group (116 cases). In both groups, they received the injection of load dosage of tilofiban into coronary artery during they underwent primary PCI, the load dosage being 25μg/kg in the large dosage group, and 10μg/kg in the routine dosage group. Afterwards, the dosage was kept on 0.15μg·kg-1·min-1 in both groups lasting for 18-24 hours. The flow of thrombolysis in myocardial infarction (TIMI) immediately after PCI, the return of ST-segment after operation for 2 hours, the rate of bleeding events, the rate of major adverse cardiac event [MACE, including death, re-infarction and target vessel revascularization (TVR)] and prognosis after operation for 30 days were observed. Results The ratios of the immediate reflow of TIMI 3 grade after operation and the return of ST-segment after operation for 2 hours in the large dosage tirofiban group were higher than those in the routine dosage tirofiban group [the ratio of the reflow of TIMI 3 grade:92.16%(94/102) vs. 81.90%(95/116), the ratio of the return of ST-segment after operation for 2 hours:89.22%(91/102) vs. 73.28%(85/116), both P < 0.05]. The ratios of re-infarction, TVR and the total MACE in 30 days after operation in large dosage tirofiban group were lower than those in the routine dosage tirofiban group [re-infarction: 0.98% (1/102) vs. 2.59% (3/116), TVR: 0.98% (1/102) vs. 2.59% (3/116), total MACE: 1.96% (2/102) vs. 6.03% (7/116), all P < 0.05]. There were no statistically significant differences in mortality and the bleeding events between the large dosage tirofiban group and routine dosage tirofiban group [mortality:0 (0/102) vs. 0.86%(1/116), bleeding events:1.96%(2/102) vs. 0.86%(1/116), both P>0.05]. Conclusion The injection of a large dosage of tilofiban into a coronary artery in patients with STEMI undergoing primary PCI is an effective and safe method to allow them to get more clinical benefits.
