Abstract
ST-segment elevation myocardial infarction (STEMI) is one of the acute coronary syndromes, and it is the main cause of cardiac death worldwide. The purpose of this study was to investigate whether tirofiban improves cardiac function and attenuates inflammatory response in STEMI patients undergoing percutaneous coronary intervention (PCI). From May 2016 to May 2019, a total of 124 patients who admitted into our hospital due to STEMI fulfilled inclusion and exclusion criteria and were randomly assigned to PCI + tirofiban and PCI groups, 62 cases per groups. Intravenous administration of 10 μg kg−1 min−1 tirofiban was performed 30 min prior to PCI. During PCI, tirofiban infusion through a micropump with 0.15 μg kg−1 min−1 lasted for 48 h. It was found that the PCI + tirofiban group was significantly different from the PCI group in total corrected TIMI frame count (CTFC) after PCI (15.88 ± 5.11 vs. 22.47 ± 6.26, P < 0.001). At day 7 and day 30 post-PCI, a significant time-dependent decrease in the levels of brain natriuretic peptide (BNP), cardiac troponin I (cTnI), and creatine kinase isoenzyme (CK-MB) in both groups was observed after PCI (P < 0.001). More importantly, the patients in the PCI + tirofiban group had much lower levels of BNP, cTnI, and CK-MB compared with those in the PCI group at days 7 and 30 post-PCI (P < 0.001). At day 7 following PCI, the left ventricular ejection fraction (LVEF) was statistically higher in the PCI + tirofiban group than in the PCI group (P < 0.05). At day 30 post-PCI, increased LVEF concomitant with reduced left ventricular end diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) was observed in the PCI + tirofiban group compared with the PCI group. At day 7 and day 30 post-PCI, both groups displayed a time-dependent decline in the levels of C reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and procalcitonin (PCT) after PCI (P < 0.05). Additionally, the patients in the PCI + tirofiban group had lower levels of CRP, TNF-α, IL-6, and PCT compared with those in the PCI group at days 7 and 30 post-PCI (P < 0.05). All patients in the PCI + tirofiban and PCI groups were followed up for 12 months by outpatient or telephone after discharge. There were fewer patients with LVEF < 50% in the PCI + tirofiban group than the PCI group (P=0.044). Furthermore, it was found that the incidence rate of major adverse cardiovascular events (MACEs) in the PCI + tirofiban group was evidently lower than that in the PCI group (12.90% vs. 29.03%, P=0.028). Taken together, our data suggest that additional administration of tirofiban could improve cardiac function and attenuate inflammatory response in STEMI patients undergoing PCI, which is worthy of promotion in clinic.
Highlights
Acute coronary syndromes (ACS), as the general term of ischemic myocardial disease, are due to the coronary atherosclerotic plaque rupture and vascular occlusion causing secondary thrombosis, and the degree of myocardial injury is associated with the area of myocardium covered by the vessel and the duration of occlusion [1, 2]. e ACS involves non-ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction (STEMI), and myocardial infarction [3]
Is study aimed at finding out the effects of intravenous tirofiban on the cardiac function and inflammatory response for STEMI patients during percutaneous coronary intervention (PCI). ere has been more evidence indicating that tirofiban was relevant with declined infarct size and reduced rate of thrombotic incidents [32]
A variety of factors including brain natriuretic peptide (BNP), cardiac troponin I (cTnI), cardiac troponin T (cTnT), and CK-MB are associated with the cardiac function. e BNP concentration is a contributor to the diagnosis of heart failure
Summary
Acute coronary syndromes (ACS), as the general term of ischemic myocardial disease, are due to the coronary atherosclerotic plaque rupture and vascular occlusion causing secondary thrombosis, and the degree of myocardial injury is associated with the area of myocardium covered by the vessel and the duration of occlusion [1, 2]. e ACS involves non-ST-segment elevation myocardial infarction, ST-segment elevation myocardial infarction (STEMI), and myocardial infarction [3]. According to the recently published European Society of Cardiology guidelines 2017, the management and modification of STEMI compared with those in 2012 reveals that the percutaneous coronary intervention (PCI) remains a significant contributor to effective therapy in patients with STEMI [8]. It can be performed soon after diagnosis, and with lower mortality, reinfarction, and stroke rates compared with thrombolysis therapy [9, 10]. The dual antiplatelet therapy with aspirin and clopidogrel after PCI was widely used as a well-established efficacy treatment, which prevented the major ischemic events. E 2009 STEMI guidelines of the European Society of Cardiology recommended that GPIs were considered the second treatment after the standard dual antiplatelet therapy [17]. e ischemic events and thrombotic complications have been reduced when GPIs were given to STEMI patients underwent PCI [18, 19]. e tirofiban as one kind of reversible GPIs is commonly used in the cardiovascular surgery, with a result of reducing infarct size and the incidence of major adverse cardiovascular events [20]. e purpose of this study was to investigate whether tirofiban improves cardiac function and attenuates inflammatory response, preventing STEMI patients from heart injury
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
