Mei Chaosheng, Yu Huiping
Chaosheng Mei, Department of Cardiovascular Medicine, Hanyang Hospital affiliated to Wuhan University of Science and Technology, Wuhan, Hubei Province 430050, P.R. China.
Huiping Yu, Department of Cardiovascular Medicine, Hanyang Hospital affiliated to Wuhan University of Science and Technology, Wuhan, Hubei Province 430050, P.R. China.
Pak J Med Sci. 2024 Oct;40(9):1969-1974. doi: 10.12669/pjms.40.9.10101.
To compare the effectiveness of different tirofiban administration time windows in patients with no-reflow myocardial infarction (MI) during percutaneous coronary intervention (PCI).
This single centre retrospective observational study included patients with no-reflow MI, undergoing PCI at the Hanyang Hospital affiliated to Wuhan University of Science and Technology from March 2020 to May 2023. All patients were administered tirofiban. Patients who received tirofiban with postinterventional thrombolysis in myocardial infarction (TIMI) flow ≥ 1 were grouped as Group-I, and patients who were directly given tirofiban through the guiding catheter without forward blood flow were grouped as Group-II. TIMI blood flow classification, levels of cardiac troponin T (cTnT) and creatine kinase isoenzyme MB (CK-MB), incidence of complications and major adverse cardiovascular events (MACE) in the two groups before and after the treatment were statistically analyzed.
A total of 156 patients were included in this study, including 79 patients in Group-I and 77 patients in Group-II. There was no significant difference in the baseline data between the two groups (P>0.05). After treatment, TIMI blood flow classification of the two groups improved and was significantly better in Group-I compared to Group-II (<0.05). After treatment, levels of Serum cTnT and CK-MB in the two groups decreased, and were significantly lower in Group-I than in Group-II (<0.05). There was no significant difference in the incidence of complications between Group-I (3.80%) and Group-II (6.49%) (>0.05). The incidence of MACE in Group-I (3.80%) was lower than that in Group-II (12.99%) (<0.05).
Compared with the direct application of tirofiban, tirofiban given when TIMI Grade≥ 1 for patients with no-reflow MI during PCI can more effectively regulate the blood flow status of target vessels, reduce myocardial injury, and reduce the risk of MACE.
比较不同替罗非班给药时间窗对经皮冠状动脉介入治疗（PCI）期间无复流心肌梗死（MI）患者的疗效。
本单中心回顾性观察研究纳入了2020年3月至2023年5月在武汉科技大学附属汉阳医院接受PCI的无复流MI患者。所有患者均接受替罗非班治疗。心肌梗死溶栓治疗（TIMI）血流≥1且介入术后接受替罗非班治疗的患者被归为I组，通过引导导管直接给予替罗非班且无正向血流的患者被归为II组。对两组治疗前后的TIMI血流分级、心肌肌钙蛋白T（cTnT）和肌酸激酶同工酶MB（CK-MB）水平、并发症发生率及主要不良心血管事件（MACE）进行统计学分析。
本研究共纳入156例患者，其中I组79例，II组77例。两组基线数据无显著差异（P>0.05）。治疗后，两组的TIMI血流分级均有所改善，I组明显优于II组（<0.05）。治疗后，两组血清cTnT和CK-MB水平均下降，I组明显低于II组（<0.05）。I组并发症发生率（3.80%）与II组（6.49%）无显著差异（>0.05）。I组MACE发生率（3.80%）低于II组（12.99%）（<0.05）。
与直接应用替罗非班相比，PCI期间无复流MI患者在TIMI分级≥1时给予替罗非班能更有效地调节靶血管血流状态，减轻心肌损伤，降低MACE风险。
