Ren Li-hui, Peng Jian-jun, Ye Hui-ming, Wang Zuo-yan, Chen Ce
Department of Cardiology, Beijing Shijitan Hospital, Beijing, China.
Zhonghua Yi Xue Za Zhi. 2012 Jul 24;92(28):1981-3.
To evaluate the clinical outcomes of high-dose tirofiban in patients with ST-elevation myocardial infarction (ASTEMI) undergoing primary percutaneous coronary intervention (PCI).
A total of 104 consecutive ASTEMI patients undergoing primary PCI were enrolled from January 2010 to February 2011. They were randomized into the high-dose tirofiban group (n = 52) and the normal-dose tirofiban group (n = 52). We measured the sumST-segment resolution of ECG post-PCI respectively and left ventricular ejective fraction (LVEF) at Day 90 post-PCI.
After PCI, the sumST-segment resolution of ECG of the high-dose tirofiban group significantly improved than that of the normal-dose tirofiban group (38% ± 12% vs 34% ± 13%, P < 0.05). Before PCI, LVEF of two groups is 50.2% ± 1.4% vs 49.6% ± 1.1% (P > 0.05), but at day 90 post-PCI, LVEF had significant difference between two groups (60.1% ± 1.1% vs 56.0% ± 1.2%, P < 0.05). The rates of major and moderate hemorrhage did not differ significantly between two groups.
High-dose tirofiban improves myocardial reperfusion and clinical outcome. It re-emphasizes the importance of further platelet aggregation inhibition in ASTEMI patients undergoing primary PCI.
评估大剂量替罗非班在接受直接经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中的临床疗效。
选取2010年1月至2011年2月期间连续入选的104例接受直接PCI的STEMI患者。将他们随机分为大剂量替罗非班组（n = 52）和常规剂量替罗非班组（n = 52）。分别测量PCI术后心电图ST段回落总和以及PCI术后90天时的左心室射血分数（LVEF）。
PCI术后，大剂量替罗非班组心电图ST段回落总和显著优于常规剂量替罗非班组（38% ± 12% 对34% ± 13%，P < 0.05）。PCI术前，两组的LVEF分别为50.2% ± 1.4% 对49.6% ± 1.1%（P > 0.05），但在PCI术后90天时，两组间LVEF有显著差异（60.1% ± 1.1% 对56.0% ± 1.2%，P < 0.05）。两组严重及中度出血发生率无显著差异。
大剂量替罗非班可改善心肌再灌注及临床疗效。这再次强调了在接受直接PCI的STEMI患者中进一步抑制血小板聚集的重要性。
