[Effects of intracoronary or intravenous tirofiban administration in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention].
OBJECTIVE
To compare the effects on MACE of intracoronary or intravenous tirofiban bolus administration in patients with acute ST-elevation myocardial infarction (STEMI).


METHODS
A total of 60 consecutive STEMI patients ready to receive primary PCI were randomly assigned to intracoronary tirofiban bolus (10 microg/kg) prior to the first balloon inflation (Group IC) or to intravenous tirofiban bolus at the same dose prior to coronary angiography (Group IV), followed by a 36-hours IV tirofiban (0.15 microg . kg(-1) . min(-1)) infusion for all patients. Clinical and angiographic features between 2 groups before and after PCI were analyzed.


RESULTS
Fifty-four out of 60 STEMI patients accomplished the study. Group IC was superior to Group IV in terms of TIMI flow grade, TIMI myocardial perfusion grade, ST-segment resolution, the distal embolism of IRA immediately after PCI and ejection fraction at 5 - 7 days after the PCI. The in-hospital MACE rate and bleeding complications were similar between the groups while, the combined incidence of MACE during follow-up was significantly lower in the Group IC compared with Group IV (7.1% versus 30.8%; P = 0.02).


CONCLUSIONS
Intracoronary bolus application of tirofiban is associated with superior clinical prognosis compared with the standard intravenous bolus application of tirofiban in patients with STEMI undergoing primary PCI.
Yang
Xin-chun
XC
Heart Center, Beijing Chaoyang Hospital, Institute of Cardiovascular Diseases, Capital University of Medical Sciences, Beijing 100020, China.
Zhang
Da-peng
DP
Wang
Le-feng
LF
Xu
Li
L
Ge
Yong-gui
YG
Wang
Hong-shi
HS
Li
Wei-ming
WM
Ni
Zhu-hua
ZH
Xia
Kun
K
Lian
Yong
Y
Xue
Yong-li
YL
Ma
Li-Xiang
LX
D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D004562:Electrocardiography; D004638:Emergency Treatment; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D014443:Tyrosine; D000077466:Tirofiban