Impact of early tirofiban administration on myocardial reperfusion in aged patients with acute st-elevation myocardial infarction undergoing coronary stenting

Abstract

Objective To explore the effect of early application of glycoprotein (GP)Ⅱb/Ⅲa antagonist on myocardial reperfusion in elderly patients with acute ST-elevation myocardial infarction (STEMI) taken coronary stenting. Methods Patients (n=52) from 2009 to 2014 in Department of Geriatrics, Xi'nan Hospital of Third Minitary Medical University, with a first onset of AMI receiving emergency coronary stenting were randomized to either early administration of tirofiban group which were admitted with tirofiban within 30min of admission (n=26) or later administration group which were given tirofiban after 30min of admission (n=26). The primary endpoints included the degree of TIMI flow and the percentage of ST segment depression at 90min, and 30-day major adverse cardiac events.T-test was utilized to compare between two groups, and kai-square test was applied to analyze the count data. Results Angiographic analysis revealed a higher initial frequency of TIMI grade 3 flow in the early group (23% and 4%,χ2=4.13,P 0.05). ST segment depression at 90min in early group was significantly higher than in the later group (88.5% and 76.9%,χ2=1.21,P 0.05). Conclusion The early administration of tirofiban could significantly improve myocardial reperfusion and clinical outcomes in aged patients of STEMI undergoing coronary stenting. Key words: Platelet membrane glycoprotein IIb/IIIa antagonist; Acute ST-segment elevation myocardial infarction; Percutaneous coronary intervention; Myocardial ischemia; Myocardial reperfusion