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Clinical and research medicine: Heart failure and left ventricular function
e0659 The effect and safety of tirofiban combined clopidogrel in AMI patients with PCI via transradial approach
  1. Fu Xianghua,
  2. Hao Qingqing,
  3. Fan Weize,
  4. Zhang Jing,
  5. Gu Xinshun,
  6. Jiang Yunfa,
  7. Hao Guozhen
  1. The 2nd Hospital of Hebei Medical University, Shijiazhuang, Hebei, China

Abstract

Objective To evaluate the effect and safety of clopidogrel plus tirofiban in percutaneous coronary intervention (PCI) of acute myocardial infarction via transradial approach.

Methods A total of 104 patients with ST segment elevation myocardial infarction who were underwent emergency PCI were randomised into two groups: clopidogrel combined tirofiban group (n=48) and clopidogrel group (n=56). Bolus tirofiban (10 μg/kg) was infused in 3 min before PCI and then 0.15 μg/kg/min continued pumping for 24 h in the clopidogrel combined tirofiban group, while saline was used in the same way in the clopidogrel group. The TIMI flow grade in IRA before PCI, after the first guide wire getting through and instant post-PCI were recorded and compared between the two groups. The myocardial blush grade post-PCI and heart function were analysed and compared between the two groups. Hemorrhagic complications and MACE in-hospital were monitored and followed up.

Results The percentage of TIMI flow grade 1 of IRA before PCI was higher in the clopidogrel combined tirofiban group than that in the clopidogrel group (p<0.05). The percentage of TIMI flow grade 3 of IRA after the guide wire first crossing through the occlusion segment was higher in clopidogrel combined tirofiban group than that in the clopidogrel group (p<0.05). The percentage of TIMI flow grade 3 of IRA after PCI was also higher in clopidogrel combined tirofiban group than that in the clopidogrel group (p<0.05). The corrected TIMI flow count (cTFC) in the clopidogrel combined tirofiban group was smaller to the clopidogrel group (p<0.05). LVEF at 1 week after PCI in the tirofiban group was higher than that in the clopidogrel group (p<0.01). There was no significant difference in hemorrhagic complications between the two groups. The incidence rate of MACE during in-hospital in the clopidogrel combined tirofiban group was lower compared to that in the clopidogrel group (p<0.05).

Conclusions Clopidogrel combined tirofiban used during the emergency PCI for AMI via transradial approach can quickly inhibit the platelet aggregation, decrease thrombosis event, improve blood flow of IRA and increase the perfusion of myocardial microcirculation as well preserve the function of left ventricle and reduce the incidence rate of MACE during in-hospital, while not associate with increasing the incidence rate of serious haemorrhage complications.

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