Objective To analyse the efficacy and safety of tirofiban treatment combined with percutaneous coronary intervention (PCI) in the elderly with acute ST segment elevation myocardial infarction prospectively.
Methods From May 2007 to May 2009, 104 patients who presented with acute STEMI within 12 h from onset and received successful primary PCI were enrolled into the study· All patients had angiographic evidence of initial total occlusion of infarct-related artery and finally restored toTIMI3 flow after PCI· All the patients were grouped into the tirofiban group (n=54) and the control group (n=50) according to whether tirofiban was used or not· Assessment of myocardial perfusion included Myocardial Blush Grades (MBG), and the resolution of the sum of ST-segment elevation (sumSTR) at 90 min after the procedure· Left ventricular ejection fraction (EF) was measured one week later· Major adverse cardiac events in hospital and bleeding complications were also assessed.
Results Baseline clinical and angiographic characteristics of the two groups were similar.·Significant higher rates of MBG 3 were observed in the tirofiban group (88.9% vs 58.0%, p<0.05)·Patients received tirofiban were more likely to achieve higher sumSTR (70.3% vs 42.0%, p<0.05). Ejection fraction was also increased markedly in tirofiban group than the control group (56.2±7.6 vs 46.7±8.5, p<0.05)·In-hospital major adverse cardiac events were not different between the two groups· There were slightly more minor bleeding complications in the tirofiban group compared with the control (11.1% vs 6·0%, p>0.05)·No patient had major bleeding or thrombocytopaenia.
Conclusion Tirofiban can further ameliorate microvascular perfusion and is safe and feasible for patients with STEMI undergoing primary PCI·
- acute myocardial infarction
- ST segment elevation
- percutaneous coronary intervention