Effect of pretreatment with tirofiban in patients with ST-segment elevation myocardial infarction receiving emergency percutaneous coronary intervention

Objectives To investigate the effect of pretreatment with tirofiban in patients with ST-segment elevation myocardial infarction(STEMI) receiving emergency percutaneous coronary intervention(PCI). Methods From January 2009 to January 2012,186 patients with STEMI receiving emergency PCI were randomly divided into tirofiban group(group A, 95 cases, used tirofiban before PCI as early as possible) and control group(group B, 91 cases, treated with conventional treatment without tirofiban). Basic clinical characteristics, angiographic outcomes [thrombolysis in myocardial infarction(TIMI), blood flow grade and TIMI myocardial perfusion(TMP) grade], PCI efficiency and bleeding events before and after PCI were compared between the two groups. Major adverse cardiac events(MACEs) were also recorded in hospital and during 6 months ' follow-up. Results There was no significant difference between the two groups in basic clinical characteristics and preoperative angiographic features(P0.05). Compared with group B, the rates of final TIMI flow grade Ⅲ and TMP over grade Ⅱ were significantly higher in group A(96.5% vs. 81.2%, P0.05; 96.8% vs.84.2%, P0.05), while the rate of no-reflow phenomenon was obviously lower(5.6% vs.13.2 %, P0.05). There were no significant differences in MACEs and bleeding events in hospital between the two groups(P0.05). MACEs in group A during the follow-up period of the 6 months significantly reduced compared with those in group B(P0.01). Conclusions Pretreatment with tirofiban in patients with STEMI receiving emergency PCI can effectively prevent no-reflow phenomenon and improve coronary blood perfusion, save more viable myocardium, and improve the prognosis.