Effect Of Tirofiban On Recovery Of Coronary Flow And Myocardial Blush Perfusion In Patients With Acute Myocardial Infarction In Primary Percutaneous Coronary Intervention

Objective: To investigate the effects of glycoproteinⅡb/Ⅲa receptor blockade Tirofiban on coronary flow and myocardial blush perfusion in patients with acute ST-segment elevation myocardial infarction (STEMI) in primary percutaneous coronary intervention (PCI).Methods: 110 acute ST-segment elevation myocardial infarction (STEMI) patients (78 males), age 63±10(32—84) of years old, were randomized into 2 groups either Tirofiban with primary PCI (n=56) or primary PCI alone (n=54). Baseline clinical characteristics of the two groups were comparable. TIMI grade, corrected TIMI frame count (CTFC), TIMI myocardial perfusion grading (TMPG) and ST segment resolution magnitude were studied immediately after primary percutaneous coronary intervention (PCI). The MACE before and after the PCI procedure including death, new onset myocardial infarction, persistent myocardial ischemic state, post-operation left vent- ricular ejection fraction (LVEF) and drug adverse effect (bleeding, platelet reduction) were observed in all cases.Results: There was no significant difference between the two groups in baseline clinical or angiographic characteristics before primary PCI . (P﹥0.05). Percentage of TIMI 3 flow achieved in IRAs after PCI between the two groups had no significant difference (98.2% vs 92.6%,P=0.159). Lower TIMI frame count (cFTC) of IRAs (30.24±8.32 frames vs 37.72±17.68 frames, P﹤0.05), higher percentage of TIMI myocardial perfusion grading (TMPG) of IRAs (98.2% vs 77.8%, P﹤0.05), and faster ST segment resolution magnitude (73%±15% vs 61%±2%,P﹤0.05) were achieved in Tirofiban group. LVEF Post-PCI in Tirofiban group was better than that in control group (51.3±6.63 vs 48.02±9.98, P < 0.05). There were no severe hemorrhage complications (severe hemorrhage or cerebral hemorrhage) in both groups. The bleeding events tended to be more in Tirofiban group (8.9% vs 3.7%, P﹥0.05). There was no difference in the rate of hemorrhage and cardiovascular events during hospi- talization between two groups.Conclusion: Application of Tirofiban during primary PCI in patients with STEMI was safe and effective, which may improve myocardial perfusion.