Myocardial reperfusion with tirofiban injection via aspiration catheter : Efficacy and safety in STEMI patients with large thrombus burden.

Abstract

There is no consensus on the use of thrombus aspiration (TA) in primary percutaneous coronary intervention (PPCI), and few studies have focused on the performance of tirofiban via TA catheter after PPCI. Our study investigated the clinical outcome of tirofiban injection through TA in acute ST-segment elevation myocardial infarction (STEMI) patients with large thrombus burden undergoing PPCI treatment. The study comprised 122 STEMI patients who underwent TA during PPCI. Participants were randomly divided into two groups. GroupA received intravenous tirofiban injection and tirofiban injection via aTA catheter to the infarcted coronary artery after aspiration (n = 61). GroupB received intravenous tirofiban injection only (n = 61). Baseline clinical information and follow-up data were collected for both groups. Coronary angiography, electrocardiography, and echocardiography findings as well as major adverse cardiovascular events (MACE) were recorded. There were significant differences in postprocedural Thrombolysis in Myocardial Infarction (TIMI) grade2 and 3 flow between the two groups (p = 0.021, p = 0.006, respectively). The incidence of slow-flow in groupA was significantly lower than that of groupB (p = 0.011). An increased incidence of no ST-segment resolution was observed in groupB (p = 0.011). There were fewer major adverse cardiovascular events in groupA than in groupB, but the difference was not statistically significant. Selective tirofiban injection via TA catheter during PPCI may improve myocardial reperfusion in STEMI patients with large thrombus burden.