Influence of intravascular tirofiban injection in occlusion site of coronary artery on patients with acute myocardial infarction complicated with diabetes mellitus

Objective No reflow, slow flow, and cardiac function were observed in patients of acute myocardial infarction (AMI) with diabetes mellitus (DM) during emergency intervention treatment by tirofiban injection on the occlusion segment of coronary artery. Methods A total of 123 AMI combined with DM patients were enrolled into this study from March 2012 to January 2015 in our hospital.Simple randomization was used according to a randomized number which was generated by comouter.There were 59 cases in goup A which represented thrombus aspiration combined with tirofiban injection on ostium of coronary artery.Another 64 cases were in group B, which meant thrombus aspiration combined with direct injection of tirofiban in occlusion segment.of coronary artery.No reflow incidence and cardiac function were evaluated before and after tirofiban injection and half of year. Results Left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), 6 minutes walk test (6MWT) were not significantly different after one month of surgery (P>0.05). LVEF, LVEDD, 6MWT were significantly different after 3 and 6 months of surgery (P<0.05). TIMI flow of grade Ⅲ accounted for highest proportion in both grouos (83.1% and 85.9%) .No reflow incidence in group B was lower than in group A (7.8%vs.11.9%, χ2=7.319, P=0.023). The main adverse cardiovascular events was lower in group B than group A (6.3% vs 18.6%, χ2=7.789, P=0.016). Conclusions No reflow incidence decrease and cardiac function is improved by tirofiban injection in occlusion segment of coronary artery during percutaneous intervention on AMI patients complicated with DM. Key words: Acute myocardial infarction; Diabetes mellitus; Coronary occlusion; No-reflow phenomenon; Tirofiban