急性ST段抬高型心肌梗死急诊PCI术前应用替罗非班近期疗效分析

摘要

Objective To evaluate the efficacy of adjunctive use of tirofiban before percutaneous coronary intervention (PCI) in patients with acute ST elevated myocardial infarction (STEMI) through retrospective study. Methods 80 patients with acute STEMI receiving acute PCI and tirofiban were enrolled and divided into group A and group B according to when tirofiban was used. Patients in group A use tirofiban before PCI, while that in group B use tirofiban during or after PCI. The rate of TIMI grade 3 flow in the infarction related artery (IRA), major cardiovascular events and bleeding risks were compared between the two groups. Results In group A, the rate of TIMI grade 3 flow in the IRA was statistically higher compared with that of group B (25% vs 6.3%, P=0.040). Heart failure (HF) in 30 days was statistically lower (12.5% vs 33.3%, P=0.035). Bleeding risks showed no statistically significant difference. Conclusion The use of Tirofiban before acute PCI in patients with acute STEMI in early stage might improve myocardial perfusion and decrease ardiovascular events such as HF.%目的 通过回顾性分析急性ST段抬高心肌梗死(STEMI)行急诊PCI的患者应用替罗非班的时间与30d主要心血管事件之间的关系,探讨急性STEMI行急诊经皮冠脉介入治疗(PCI)患者术前应用替罗非班的短期疗效.方法 接受急诊PCI的急性STEMI且应用替罗非班的患者共80例,按使用替罗非班的时间随机分为早期应用组和延迟应用组,比较两组冠脉造影TIMI血流分级情况、主要心血管事件发生率、出血风险等.结果 早期应用组初次冠脉造影梗死相关动脉(IRA)TLMI 3级血流获得率显著高于延迟应用组(25％vs 6.3％,P=0.040).早期应用组30d心衰(HF)发生率显著低于延迟应用组（12.5％ vs 33.3％,P=0.035）.两组间出血风险差异无统计学意义(P=0.670).结论 急性STEMI患PCI术前即开始应用替罗非班,可能有助于早期改善心肌灌注,降低近期HF等临床事件发生率.