Effect of intracoronary tirofiban in patients undergoing percutaneous coronary intervention for acute coronary syndrome.
BACKGROUND
To investigate the efficacy of intracoronary tirofiban during primary percutaneous coronary intervention (PCI) for patients with acute coronary syndrome (ACS).


RESULTS
The 118 patients aged 70 years and above (average age 75+/-2) were divided into study (n = 58, intracoronary bolus tirofiban) and control (n = 57, intravenous tirofiban) groups. The culprit vessels were targeted with primary PCI in all patients. Compared with the control group, the study group showed better Thrombolysis In Myocardial Infarction (TIMI) flow grades and TIMI myocardial perfusion grades (TMPG) immediately after PCI (p = 0.016 and 0.026, respectively). The 14-day composite major adverse cardiac events rate was lower in the study group (3.5% vs 17.5%, p = 0.030), but was similar between the 2 groups at 30 days following PCI (7.0% vs 1.7%, p = 0.350). The left ventricular ejection fraction in the study group was higher than in the control group 30 days following PCI (67.4+/-6.2% vs 60.7+/-4.6%, p = 0.033). The 14-day bleeding complication (p = 0.201) and platelet reduction rates (p = 0.984) were similar between the 2 groups.


CONCLUSIONS
In patients with ACS undergoing primary PCI, intracoronary bolus administration of tirofiban is superior to intravenous bolus injection for improving coronary flow, myocardial perfusion and short-term clinical outcomes.
Wu
Tong-Guo
TG
Department of Cardiology, The Red Cross Hospital of Guangzhou City, Fourth Affiliated Hospital of Jinan University, Guangzhou, PR China.
Zhao
Qiang
Q
Huang
Wei-Guang
WG
Wei
Jian-Rui
JR
Chen
Si-Wei
SW
Zhao
Jin
J
Huang
Li-Ping
LP
Wang
Le-Xin
LX