The Influence Of Tirofiban To ST-segment Elevation Myocardial Infarction With Ischemic J-waves In ECG

Objective: To evaluate the influence of tirofiban, the platelet GPâ…¡b/â…¢a receptor antagonist, in the treatment of ST-segment elevation myocardial infarction (STEMI) with ischemic J waves onset undergoing percutaneous coronary intervention(PCI) in ECG and assessment of their prognosis in the near future.Methods: In this study, 45 cases occurred within 12 hours of ST-segment elevation myocardial infarction patients with ischemic J-waves in The First Hospital Of JiLin University from 2004 to 2008. They were divided into therapy group (tirofiban) and control group (placebo tirofiban). The use of tirofiban in therapy group can last from 24 to 48 hours. Observe the changes of J waves, ST segments and T waves in ECG during medication and the incidence of arrhythmias in 24 hours and major cardiovascular events (MACE) during hospitalization occurrence.Results: ECG results showed that the J waves of therapy group disapp- eared in 2 hours and J-point and ST segment elevation of the therapy group dropped significantly in the early stage after percutaneous coronary intervention (PCI) and malignant ventricular arrhythmias were significantly reduced than the control group (P<0.05). The level of CK-MB are also different between this two groups, the therapy group is lower than the control group in 6 hours and 12 hours after PCI(P<0.05). There was no significant difference in the incidence of MACE during hospitalization between the two groups (P>0.05), but the tirofiban group is lower.Conclusion: Therefore, tirofiban could more thoroughly inhibit the aggre- gation of platelets in the site of coronary atherosclerosis and effectively control the damage to vascular endothelial cells,which was associated with PCI operation, so it could be more effective in the prevention of platelet thrombus formation during the operation of PCI. It also can improve the reperfusion of small ischemic vasculars in myocardials, therefore, tirofiban may reduce myocardial injury and improve ischemic J waves in ECG, so that the J-point and ST segment elevation can fall to the baseline in the early stage, and there exist a significant reduction in the case of malignant ventricular arrhythmia incidence. Therefore, it may incerase the good effects of percutaneous coronary intervention (PCI) and reduce mortality in the near future.