Evaluation on the efficacy and safety of intracoronary eptifibatide only during primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

Abstract

Objective To evaluate the efficacy and safety of intracoronary eptifibatide only during primary percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods The 52 STEMI patients were randomly divided into two groups according their random number created by computer : the intracoronary group (n=26) and the intravenous group (n=26). Postoperative TIMI flow grade (TFG), corrected TIMI flow frames (cTFC), 90 min postoperative ST segment resolution (STR), postoperative cardiac function parameters, and any bleeding events during hospitalization and after 30 day major adverse cardiac events (MACE) were recorded and analyzed after completion of primary PCI. Results There was no significant difference between the two groups with regard to the TFG (χ2=2.44, P=0.313), MACE (3.8% vs.0, χ2=0.00, P=1.000), left ventricular ejection fraction (58.54%±4.56% vs.56.62%±6.69%, t=1.211, P=0.232), left ventricular end-diastolic dimension [(49.96±4.85) mm vs.(51.42±6.35) mm, t=0.962, P=0.351] and regional wall motion abnormality (80.77%vs.73.08%, χ2=0.435, P=0.510). Compared with intravenous group, the ratio of complete STR in intracoronary group was significantly higher (88.46%vs.61.54%, χ2=5.24, P=0.025) and the cTFC was shorter (16.44±4.61 vs.18.30±5.61, t=2.30, P=0.028). The bleeding rate was not statistically significant between the two groups (3.85% vs.11.54%, χ2=1.063, P=0.303). Conclusions The intracoronary eptifibatide only strategy, which may improve microvascular perfusion demonstrated by an improved STR and cTFC, is an alternative regimen for patients with acute STEMI undergoing primary PCI. Key words: Eptifibatide; Angioplasty, transluminal, percutaneous coronary; Myocardial infarction