Objective To evaluate the efficacy and short term prognosis of tirofiban in different treatment duration in patients with acute ST segment elevation myocardial infarct (STEMI) and percutaneous coronary intervention (PCI) combined with intracoronary injection.
Methods A total of 125 patients with acute STEMI were enrolled in the trial. They were randomly divided into 2 groups:tirofiban group (n = 64) and control group (n = 61). The tirofiban was used by intracoronary and intravenous application in tirofiban group which was randomly divided into 3 sub-groups again according to the duration of tirofiban by persistent intravenous injection for 12 hours, 24 hours or 36 hours. Thrombolysis in myocardial infarction flow (TIMI flow) and myocardial perfusion grades were recorded immediately after PCI. The adverse cardiac events and cardiac death within 180 days of PCI, and the adverse effects (haemorrhage and thrombocypenia) were compared between the 2 groups and within tirofiban sub-groups.
Results Grade 3 inmyocardial perfusion was significantly better in tirofiban group (85.50%) than control group (72.13%, P = 0.046) after PCI. There was one cardiac death in control group in 180 days after PCI. The adverse cardiac event rates between two groups was significant difference (16 patients in control group and only 8 in tirofiban group, P = 0.047 by survive analysis). There was no significant difference in occurrence of haemorrhage complications and platelet counts between two groups. Nevertheless, haemorrhage complications in the 12 and 24-hour groups were less than 36-hour group within tirofiban groups (P = 0.01).
Conclusions Intravenous tirofiban treatment reduced the composite occurrence of the adverse cardiac events and improved short term prognosis without increasing the adverse reactions of the drugs in patients undergoing PCI. The less haemorrhage complication can be achieved in less duration of tirofiban by intravenous injection after PCI.