Effects of intracoronary arterial injection of tirofiban on no reflow treatment in patients with acute ST-segment elevation myocardial infarction underwent primary percutaneous coronary intervention

Abstract

Objective To compare the effect of intracoronary injection of tirofiban and sodium nitroprusside(SNP)on no reflow phenomenon during primary percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI). Methods A total of 68 patients with acute STEMI who had no reflow phenomenon during PCI were randomly divided into SNP group(n=34)and tirofiban group(n=34). Intracoronary injection of tirofiban was given in tirofiban group, while intracoronary bolus SNP was given in SNP group, TIMI flow grade of infarct-related artery was recorded after 10 minutes.Plasma brain natriuretic peptide(BNP)before and 24 hours after PCI, left ventricular ejection fraction(LVEF), left ventricular end-diastolic dimension(LVEDD), left ventricular end-systolic dimension(LVESD)were recorded and compared after 30 days. Results The rate of TIMI grade 3 blood flow in tirofiban group was significantly greater than SNP group(76.5% vs. 52.9%, P=0.03). BNP levels were similar between the two groups before PCI(P=0.16), but in tirofiban group were significantly lower than SNP group after PCI [(439.00±4.90)μmol/L vs.(632.00±3.63)μmol/L, P=0.02]. LVEF, LVEDD, LVESD at 30 days in tirofiban group were significantly higher than those in SNP group(all P<0.05). Conclusions Intracoronary injection of tirofiban is superior to SNP in improving no-reflow phenomenon after primary PCI in STEMI patients.Tirofiban therapy can increase coronary blood flow and myocardial perfusion after occurring of no-reflow phenomenon during primary PCI in STEMI patients, improve long-term prognosis. Key words: Angioplasty, transluminal, percutaneous coronary; No-reflow phenomenon; Tirofiban; Sodium nitroprusside