Abstract
Objective To investigate the effect of intracoronary tirofiban on myocardial reperfusion and endothelial function in patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary intervention (PCI). Methods Totally 114 patients with AMI treated by emergency PCI were divided randomly into the tirofiban group (58 cases) and control group (56 cases). In the tirofiban group, tirofiban was administered intravenously as a bolus injection at a dose of 10 μg/kg followed by intravenous infusion at 0.075 μg·kg-1·min-1 for 24 to 48 hours, while patients in the control group did not took tirofiban treatment. Thrombolysis in myocardial infarction (TIMI) flow grade was assessed by coronary angiography picture at the end of PCI. The levels of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), von Willeband factor (vWF) and high-sensitivity C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay (ELISA). Serial venous blood samples were obtained before and 1 day after PCI. Results Compared with the control group, the proportion of TIMI grade 3 flow in the tirofiban group was significantly higher (79.3% vs 50.0%, χ2 = 10.747, P 0.05). 24 h after the treatment, the levels of sICAM-1[(24.2 ± 2.3) μg/L vs. (37.1 ± 3.3) μg/L], sVCAM-1[(26.2 ± 2.9) μg/L vs. (43.1 ± 3.8) μg/L]、vWF[(514 ± 135) U/L vs.(588 ± 126) U/L] in the tirofiban group were significantly lower than those in the control group (all P < 0.05); 72 h after the treatment, the levels of sICAM-1 [(22.4 ± 1.8) μg/L vs. (32.4 ± 2.5) μg/L], sVCAM-1[(23.7 ± 2.2) μg/L vs. (38.9 ± 2.6) μg/L], vWF [(586 ± 145) U/L vs. (678 ± 144) U/L], hs-CRP [(7.2 ± 2.7) mg/L vs. (8.5 ± 3.5) mg/L] in the tirofiban group were significantly lower than those in the control group (all P < 0.05). Conclusion Intracoronary injections of tirofiban to AMI patients during emergency PCI could improve myocardial tissue perfusion and endothelial function. Key words: Tirofiban; Myocardial infarction; Percutaneous coronary intervention; Myocardial reperfusion; Endothelial function
Published Version
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