Efficacy and Safety of Thrombectomy Combined with Intracoronary Administration of Tirofiban in ST-segment Elevation Myocardial Infarction (STEMI)
Lu Gao, Zhenhua Cao, Hong Zhang
Department of Cardiology, Tianjin Nankai Hospital, Tianjin, China (mainland)
Med Sci Monit 2016; 22:2699-2705
No/slow reflow gives rise to serious complications in STEMI patients undergoing PCI, and can lead to worse outcomes. Several measures are used to prevent no/slow reflow, including thrombus removal processes and intensive use of anticoagulant agents. Our study was designed to evaluate the efficacy and safety of thrombectomy and intracoronary administration of GPIIb/IIIa inhibitors in STEMI patients undergoing PPCI.
MATERIAL AND METHODS: We randomly assigned 240 STEMI patients into 3 groups. Before PPCI, patients in group A received thrombectomy and intracoronary administration of tirofiban. Patients in group B received thrombectomy, and patients in group C neither of these 2 treatments. Their demographic data and coronary angiography results were recorded. TIMI grade flow was used to evaluate the effect. After the follow-up, major adverse cardiac events were regarded as study endpoints in evaluating the safety of the combined therapy.
RESULTS: We found no significant differences among the 3 groups in demographic and clinical characteristics (p>0.05). Patients in group A had better TIMI grade classifications and ST-segment elevation (p=0.005), and lower incidence of no/slow reflow (p=0.031) and MACE. During 6-month follow-up, the MACE rate was lower in group A than in groups B and C (p=0.038).
CONCLUSIONS: The use of thrombectomy combined with intracoronary administration of tirofiban is relatively effective and safe in STEMI patients undergoing PPCI.
Keywords: Anticoagulants - therapeutic use, Angioplasty, Balloon, Coronary - methods, Combined Modality Therapy, Coronary Angiography - methods, Percutaneous Coronary Intervention - methods, Platelet Aggregation Inhibitors - adverse effects, ST Elevation Myocardial Infarction - surgery, Thrombectomy - methods, Thrombosis - etiology, Tyrosine - analogs & derivatives