title: [Effect of intracoronary tirofiban combined with nitroprusside injection through thrombus aspiration catheter during primary percutaneous coronary intervention on acute anterior myocardial infarction patients with heavy thrombosis burden].
abstract: OBJECTIVE
  To explore the impact of intracoronary bolus administration of tirofiban combined with nitroprusside through thrombus aspiration catheter or thrombus aspiration alone on myocardial reperfusion and major adverse cardiovascular events rate in acute anterior myocardial infarction patients with heavy thrombosis burden.
  
  
  METHODS
  Ninety consecutive acute anterior myocardial infarction patients with heavy thrombosis burden [(59.8 ± 11.5) years old] were randomly assigned to thrombus aspiration group (Group A, n = 30), thrombus aspiration and intracoronary tirofiban bolus (25 µg/kg prior to the first balloon inflation,Group B, n = 30), thrombus aspiration and intracoronary tirofiban combined with nitroprusside bolus (200 µg prior to the first balloon inflation, Group C, n = 30) with random number table. Baseline clinical data, angiographic features before and after percutaneous coronary intervention (PCI) and major adverse cardiovascular events after PCI between 3 groups were compared.
  
  
  RESULTS
  The baseline clinical data and angiographic features among 3 groups were similar (all P > 0.05) . The time of pain to balloon was (5.5 ± 3.8) hours. After primary PCI, myocardial tissue perfusion was significantly better in Group C than in Group A and Group B: TMP grade < 3 [10.0% (3/30) vs. 40.0% (12/30) and 33.3% (10/30), P < 0.01 and P < 0.05]. Left ventricular ejection fraction at 5 to 7 days after PCI also tended higher in Group C than in the other 2 groups (P = 0.05). One patient died of heart failure at 7th day after PCI in Group A, and no patient died in Group B and C. Thirty days after PCI, there was no re-myocardial infarction and target vessel revascularization event among 3 groups. The bleeding complication rate during 30 days follow-up was similar among 3 groups (P > 0.05) .
  
  
  CONCLUSIONS
  Intracoronary bolus application of tirofiban combined with nitroprusside through thrombus aspiration catheter after thrombus aspiration is associated with an improvement of myocardial reperfusion without increasing bleeding complication and other adverse cardiovascular events rate compared with thrombus aspiration alone in patients with acute anterior myocardial infarction and heavy thrombosis burden undergoing primary PCI.
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Dapeng
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China. Email: wlf311@126.com.
authors.forename: Lefeng
authors.initials: L
authors.lastname: Wang
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Jinquan
authors.initials: J
authors.lastname: Du
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Hongshi
authors.initials: H
authors.lastname: Wang
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Li
authors.initials: L
authors.lastname: Xu
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Weiming
authors.initials: W
authors.lastname: Li
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Zhuhua
authors.initials: Z
authors.lastname: Ni
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Xia
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Heart Center, Beijing Chaoyang Hospital affiliated to Capital Medical University,Beijing 100020, China.
authors.forename: Xinchun
authors.initials: X
authors.lastname: Yang
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D003328:Coronary Thrombosis / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000628:therapy; D009599:Nitroprusside / Q000627:therapeutic use*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D013396:Suction; D000077466:Tirofiban; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D009599:Nitroprusside; D014443:Tyrosine; D000077466:Tirofiban