Effect of tirofiban on myocardial reperfusion injury and recent prognosis in patients undergoing percutaneous coronary intervention

Abstract

Objective To explore the effect of tirofiban on myocardial reperfusion injury and recent prognosis in patients with acute myocardial infarction by emergency percutaneous coronary intervention. Methods Ninety-three patients with acute myocardial infarction treated undergoing emergency percutaneous coronary intervention were selected and divided randomly into treatment group (n=48, 10 μg/kg bolus followed by 0.15 μg·kg-1· min-1 infusion 36 hours) and control group (n=45, no tirofiban). Thrombolysis in myocardial infarction flow grade was assessed from coronary angiography picture at the end of percutaneous coronary intervention. Plasma concentrations of creatine kinase, MB form, cardiac troponin I, hypersensitive C-reactive protein and von willebrand factor were measured by enzyme-linked immunosorbent assay, blood samples were obtained before and after percutaneous coronary intervention. The major adverse cardiac events of postoperative 6 months were recorded and compared between two groups of patients. SPSS 19.0 statistical software package be used to analyze the data, measurement data was compared between groups by t test, while count data was compared between groups by chi-square test. Results Compared with control group, TIMI3 flow degree of treatment group in the last coronary angiography picture after percutaneous coronary intervention was higher, the difference was statistically significant (χ2=8.283, P=0.004). At 12 hours after percutaneous coronary intervention, creatine kinase, MB form of treatment group (14.34±3.12) U/L was lower than control group(15.65±2.53) U/L, the difference was statistically significant (t=2.215, P=0.029). At 24 hours after percutaneous coronary intervention, cardiac troponin I, of treatment group (0.124±0.235) ng/mL was lower than control group(0.239±0.312) ng/mL, the difference was statistically significant (t=2.016, P=0.047). At 12 and 24 hours after percutaneous coronary intervention, von willebrand factor of treatment group(512.28±135.73) U/L, (584.63±143.38) U/L was significantly lower than control group(575.72±126.41) U/L, (667.59±145.35) U/L, the difference was statistically significant (t=2.328, 2.770, P=0.022, 0.007). At 24 hours after percutaneous coronary intervention, hypersensitive C-reactive protein of treatment group (7.32±2.75) mg/L was significantly lower than control group(8.74±3.62) mg/L, the difference was statistically significant (t=2.138, P=0.035). The major adverse cardiac events (including recurrence of angina pectoris, myocardial infarction) of postoperative 6 months in treatment group was lower than control group, there was no statistically significant difference(P>0.05). Two groups had no deaths. Conclusion Tirofiban used for acute myocardial infarction patients during emergency percutaneous coronary intervention could decrease myocardial tissue perfusion injury and inflammation, but the major adverse cardiac events of postoperative 6 months were not reduced in statistics. Key words: Myocardial infarction; Reperfusion injury; Prognosis; Tirofiban; Percutaneous coronary intervention; Inflammatory response