Efficacy and safety of tirofiban treatment combined with percutaneous coronary intervention in the elderly with acute ST segment elevation myocardial infarction

Abstract

Objective To analyze the efficacy and safety of tirofiban treatment combined with percutaneous coronary intervention (PCI) in the elderly with acute ST segment elevation myocardial infarction prospectively. Methods From May 2008 to May 2010, 106 patients who presented with acute STEMI within 12 hours from onset and received successful primary PCI were enrolled into the study. All patients had angiographic evidence of initial total occlusion of infarct-related artery and finally restored toTIMI3 flow after PCI. All patients were divided into tirofiban group (n = 54) and control group (n = 52) according to whether tirofiban was used or not. Assessment of myocardial perfusion included Myocardial Blush Grades (MBG), and the resolution of the sum of ST-segment elevation (sumSTR) at 90 minutes after the procedure. Left ventricular ejection fraction (EF) was measured one week later. Major adverse cardiac events in hospital and bleeding complications were also assessed. Results Baseline clinical and angiographic characteristics of the two groups were similar. Significant higher rates of MBG 3 were observed in the tirofiban group (88. 9% vs57. 7%, P ＜ 0.05). Patients received tirofiban were more likely to achieve higher sumSTR (70. 3% vs 42. 3%, P ＜0. 05). Ejection fraction was also markedly increased in tirofiban group than control group (56. 2 ± 7.6 vs 46. 7 ± 8. 5, P ＜ 0. 05). In-hospital major adverse cardiac events, it was not different between the two groups(P ＞0. 05). There were slightly more minor bleeding complications in tirofiban group compared with control(11.1% vs 6. 0%, P ＞0. 05). No patient had major bleeding or thrombocytopenia.Conclusions Tirofiban can further ameliorate microvascular perfusion and it is safe and feasible for patients with STEMI undergoing primary PCI. Key words: Angioplasty, transluminal, percutaneous coronary; Platelet membrane glycoproteins/AL/AD; Tyrosine/AA/AD; Myocardial infarction/TH