Objectives Spontaneous reperfusion (SR) occurs in 7–27% of patients undergoing percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) and improves clinical prognosis. Our objective was to assess whether the glycoprotein IIb/IIIa inhibitor tirofiban elevates the incidence of SR and improves clinical prognosis in patients with STEMI undergoing PCI.
Methods The study included 508 consecutive patients with STEMI undergoing PCI who were followed at 30 and 90 days. Clinical data, including baseline clinical characteristics and angiographic and laboratory features were compared between patients with and without SR. Clinical outcomes in hospital and at 30-day and 90-day follow-up were compared between patients treated with and without tirofiban.
Results SR was observed in 162 patients (31.89%). By multivariate logistic regression analysis, use of tirofiban (OR 2.32, CI 1.25 to 4.31, P = 0.008) independently predicted the occurrence of SR. Kaplan-Meier survival analysis demonstrated that major adverse cardiovascular event (MACE)-free survival was significantly higher in patients treated with tirofiban than in patients without tirofiban at 30-day (log rank = 11.65, P = 0.001) and 90-day follow-up (log rank = 16.79, P < 0.001). Cox regression analysis demonstrated that administration of tirofiban was a powerful predictor of 30-day MACE (HR = 0.479, 95%CI 0.265 to 0.865, P = 0.015) and (HR = 0.478, 95% CI 0.276 to 0.828, P = 0.008).
Conclusions Tirofiban increases the incidence of SR and improves clinical prognosis in patients undergoing PCI for STEMI at 30-day and 90-day follow-up.