Effect of tirofiban on myocardial perfusion after primary percutaneous intervention in patients with acute ST-segment elevated myocardial infarction at early stage

Objective To investigate the effect of platelet glycoprotein IIb/IIIa receptor blockade with tirofiban on myocardial perfusion after primary percutaneous coronary intervention(PCI) in patients with ST-segment elevated myocardial infarction(STEMI) at early stage.Methods One hundred and eight patients with acute STEMI for the first time receiving successful primary PCI through radial artery in CCU of Yuncheng Central Hospital from May 2007 to November 2010 were enrolled.All the patients were grouped into tirofiban group(n=54)and control group(n=54) according to the use of tirofiban or not.The clinical features and TIMI grading before and after PCI were compared.TIMI myocardial perfusion grading(TMPG),the sum of ST-segment elevation(sumSTR) and QT dispersion(QTd) in 2 h after PCI were recorded and compared.Bleeding complications were also observed.Results Clinical baseline before treatment was similar in two groups.The rate of TIMI3 was higher in tirofiban group than in control group before operation(29.63% vs 11.11%,P=0.03),while the rate of TIMI3 was not significantly different between 2 groups after PCI.In tirofiban group the rates of TMPG3 and sumSTR were higher than in control group after PCI(TMPG3:94.44% vs 74.07%,P=0.01;sumSTR:88.89% vs 68.52%,P=0.02).Compared with control group,QT dispersion decreased significantly in tirofiban group(51.11±8.91 vs 24.80±4.26,P0.001).The rate of minor bleeding complications in tirofiban group was higher than in control group,but there was no significant difference(9.26% vs 3.70%,P=0.43).No patient had major bleeding or thrombocytopenia.Conclusion Tirofiban can further improve the microvascular perfusion,and it is safe and feasible for patients with acute ST-segment elevated myocardial infarction undergoing primary PCI.