Influence of intracoronary tirofiban on no-reflow phenomenon after percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction SU

Abstract

Objective To evaluate the influence of intracoronary tirofiban on the incidence of no reflow after percutaneous coronary intervention ( PCI ) in patients with acute ST segment elevation myocardial infarction ( STEMI ).Methods 120 STEMI patients were divided into tirofiban group ( tirofiban and direct PCI,n =60 ) and control group ( direct PCI,n =60 ).During PCI,coronary flow was evaluated according to TIMI flow grading and corrected TIMI frame count ( cTFC ).The changes in sum ST segment resolution ( sumSTR ) were compared one hour after PCI; myocardial perfusion defect score index ( CSI ) and wall motion score index ( WMSI ) were computed 24 hours after PCI according to myocardial contrast echocardiography ( MCE ).Results The blood flow of TIMI grade 3 was greater in tirofiban group than in the control group ( P ＜ 0.05 ) and cTFC was significantly lower in tirofiban group than in the control group ( P ＜ 0.01 ); CSI and WMSI were was significantly lower in tirofiban group than in the control group ( 1.23 + 0.33 vs.1.38 + 0.43,1.52 + 0.39 vs.1.70 ± 0.38; P＜ 0.05 );,the ratio of sumSTR ＞ 70％ was significantly higher in the tirofiban group than in the control group ( P ＜ 0.05 ).Conclusions Intracoronary tirofiban can improve myocardial blood flow in STEMI patients after PCI and can prevent the occurrence of no reflow. Key words: Myocardial infarction; Tirofiban; Percutaneous coronary intervention; No reflow