Influence of early application of tirofiban in patients with acute myocardial infarction after emergency percutaneous coronary intervention

Objective:To observe influence of early application of tirofiban on myocardial perfusion and short-term effect in patients with acute myocardial infarction(AMI) after emergency percutaneous coronary intervention(PCI).Methods:A total of 113 AMI patients undergoing primary PCI were randomly divided into early tirofiban group(n=60,after identified diagnosis,patients received loading dose tirofiban of 10 μg/kg intravenously,followed by tirofiban 0.15μg·kg-1·min-1 continuous infusion for 48h) and routine treatment group(n=53,received tirofiban at the beginning of coronary angiography,the method and dosage of administration were the same as early tirofiban group).TIMI blood flow condition in infarct related artery(IRA) before and after PCI,TIMI myocardial perfusion grade(TMPG) after PCI,ST-segment resolution,cardiac function after PCI and incidence rate of major adverse cardiac events(MACE) during admission were compared between two groups.Results:Percentage of patients with TIMI blood flow grade 2 in early tirofiban group was significantly higher than that of routine treatment group(13.3% vs.1.9%,P=0.037),there was no significant difference in TIMI blood flow instant after PCI between two groups(P=0.188);compared with routine treatment group after PCI,there were significant increase in percentages of patients with TMPG grade 3(73.6% vs.88.3%,P=0.034) and patients with ECG ST segment resolution50% 2h after PCI(60.4% vs.78.3%,P=0.038) in early tirofiban group.There were no significant difference in LVEF and incidence rate of MACE 7d after PCI between two groups(P0.05).Conclusion:Early application of tirofiban can improve TIMI blood flow and myocardial perfusion after PCI without increase in incidence rate of MACE during admission.