Objective To investigate the efficacy and safety of platelet glycoprotein IIb/IIIa inhibition (tirofiban) during PCI in AMI patients performed primary PCI.
Methods A total of 96 patients with AMI were randomised to divide into two groups: the tirofiban group (TG, n=44,) and the control group (CG, n=52). Tirofiban was only administrated in the tirofiban group. Before the CAG, enough clopidogrel, aspirin and heparin be used in both groups. The MACE and the haemorrhage events were collected in each group during in-hospital. The lesion and reperfusion of the IRA and myocardial were analyses by QCA and TMPG. The platelet aggregation rate were recorded All patients received UCG 1 week and 24 weeks after PCI to evaluate the heart function.
Results There was no significant differences in age, gender, risk factors, pre-angina, the location of the AMI, heart function, and the mean interval from onset to PCI between the two groups. A greater percentage of TIMI 1 flow of IRA was achieved in TG compared with the control group before PCI (p<0.05). The percentage of TIMI 3 flow of IRA after the guild wire first crossing was higher (p<0.05) in TG. The percentage of TIMI 3 flow in TG after PCI was higher than that in CG (p<0.05). The CTFC and slow-reflow phenomenon was fewer (p<0.05) in TG after PCI. The percentage of TMPG beyond 2 grade was higher in TG p<0.05). The value of LVEF 1 week after PCI in TG was higher than that in CG (p<0.01). The platelet aggregation rate in TG was lower after tirofiban administration for 0.25, 0.5, 2, 6 and 12 h. There was no significant difference in haemorrhage events between the two groups. There was a lower incidence of MACE in TG compared with that in CG during in-hospital and follow up.
Conclusion Intravenous administration of trofiban can inhibit the platelet aggregation, improve the coronary flow of IRA, decrease the incidence of NRP in AMI patients performed PCI, which in turn will improve the heart function and decrease the incidence of MACE. Tirofiban can make more IRA patent before PCI, but do not increase the haemorrhage events.