Effects of Tirofiban on Microvascular Dysfunction and Early Left Ventricular After Remodeling Primary Percutaneous Coronary Intervention

Objective:To study the effects of glycoprotein Ⅱb/Ⅲa receptor blockade with tirofiban on microvascular dysfunction and early left ventricular remodeling(LVR)in patients with acute myocardial infarction(AMI)treated by primary percutaneous coronary intervention(PCI).Methods:One hundred and four patients with first AMI were randomized to receive either tirofiban and primary PCI(n=52)or primary PCI alone(n=52).TIMI grade,corrected TIMI frame count(cTFC)and myocardial blush grade were compared immediately after primary PCI.The indexes of left ventricular shape,geometry were measured at early(24 h),1,2 and 3 weekends after AMI by echocardiography.Results:There was no difference between two groups in TIMI frame 3 flow(P0.05).Fewer cTFC(P0.05)and higher myocardial blush grade 3(76.9%vs 53.8%,P0.05)were obtained in tirofiban group.The changes of left ventricular shape and geometry in control group were more obvious than tirofiban group,and progressively worsened from 1 to 3 weeks,reading the most obvious peak value 3 weeks(P0.05).Conclusion:Tirofiban in patients with AMI after primary PCI was more effective in inhibitory action of LVR and in the improvement of microvascular dysfunction.