Study on Tirofiban before Primary Percutaneous Coronary Intervention in Patients with Acute ST-elevation Myocardial Infarction

Objective:To assess the safety and efficacy of tirofiban administration before primary percutaneous coronary intervention(PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI) .Methods:From March 2006 to April 2007,105 patients with acute STEMI preparing for primary PCI were randomized to tirofiban group(administration before PCI,n = 47) or control group(n = 58) .Clinical and angiographic features including TIMI grade flow(TGF) before and after PCI,corrected TIMI frame count(cTFC) ,operation time,contrast medium consumption,and hemorrhage complications were ana-lyzed.Results:Baseline clinical characteristics before PCI were similar between the two groups.TIMI2-3 flow rate of infarction related artery(IRA) in tirofiban group at initial angiography before PCI were significantly higher than that in control group(36.2% vs 17.2%,P = 0.035) .There was no difference between the two groups in TIMI flow after PCI,but fewer TIMI frames were achieved in tirofiban group(24.3±7.6 vs 37.2±10.2,P 0.01) .Operation time[(36.4±8.5) min vs(51.7±11.3) min,P 0.01) ] and contrast medium consumption[(113.6±17.4) mL vs(168.2±26.5) mL,P 0.01) ] in tirofiban group were decreased signif-icantly.Hemorrhage rate in tirofiban group was higher,but there was no difference between two groups.Conclusion:Administra-tion of tirofiban before primary percutaneous coronary intervention(PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI) may improve patency and TIMI flow of the IRA,and facilitate the operation without increased hemorrhage.