Ji Zhen-Guo, Liu Hong-Bin, Liu Zhi-Hong, Ma Guo-Ping, Qin Li-Qiang, Dong Wei, Wang Li-Ya
The Third Affiliated Shijiazhuang Hospital of Hebei Medical University, The Third Hospital of Shijiazhuang City, Shijiangzhuang, Hebei 050011, China.
The First Hospital of Hebei Medical University, Hebei 050031, China.
Chronic Dis Transl Med. 2015 Jul 6;1(2):81-88. doi: 10.1016/j.cdtm.2015.06.003. eCollection 2015 Jun.
To evaluate the efficacy and short term prognosis of Tirofiban in different treatment duration in patients with acute ST segment elevation myocardial infarction (STEMI) and percutaneous coronary intervention (PCI) combined with intracoronary injection.
A total of 125 patients with acute STEMI were enrolled in this study. They were randomly divided into two groups: control group ( = 61) and Tirofiban group ( = 64). The Tirofiban was used by intracoronary and intravenous administration in Tirofiban group which was randomly divided into three sub-groups according to the duration of Tirofiban by persistent intravenous injection for 12 hours, 24 hours or 36 hours. Thrombolysis in myocardial infarction 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 (hemorrhage and thrombocytopenia) were compared between the two groups and within Tirofiban sub-groups.
Grade 3 in myocardial perfusion was significantly better in Tirofiban group than control group (85.94% 72.13%, = 0.03) 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, = 0.047). There was no significant difference in incidence of hemorrhage complications and platelet counts between two groups. Nevertheless, hemorrhage complications in the 12- and 24-hour subgroups were less than 36-hour subgroup ( = 0.01).
Intravenous Tirofiban treatment reduced the adverse cardiac events and improved short term prognosis without increasing the adverse reactions of the drugs in patients undergoing PCI. The less rate of hemorrhage complication can be achieved in short-duration of Tirofiban by intravenous injection after PCI.
评估替罗非班在不同治疗时长下对急性ST段抬高型心肌梗死（STEMI）患者行冠状动脉介入治疗（PCI）并冠脉内注射的疗效及短期预后。
本研究共纳入125例急性STEMI患者。将其随机分为两组：对照组（n = 61）和替罗非班组（n = 64）。替罗非班组采用冠脉内及静脉给药，根据持续静脉注射替罗非班12小时、24小时或36小时的时长随机分为三个亚组。PCI术后立即记录心肌梗死溶栓血流及心肌灌注分级。比较两组及替罗非班亚组在PCI术后180天内的不良心脏事件及心源性死亡情况，以及不良反应（出血和血小板减少）。
PCI术后替罗非班组心肌灌注3级明显优于对照组（85.94%对72.13%，P = 0.03）。对照组在PCI术后180天内有1例心源性死亡。两组不良心脏事件发生率有显著差异（对照组16例，替罗非班组仅8例，P = 0.047）。两组出血并发症发生率及血小板计数无显著差异。然而，12小时和24小时亚组的出血并发症少于36小时亚组（P = 0.01）。
静脉应用替罗非班治疗可减少接受PCI患者的不良心脏事件，改善短期预后，且不增加药物不良反应。PCI术后短期静脉注射替罗非班可降低出血并发症发生率。
