ABSTRACT
Objective To analyse and compare the effects and safety of early use (in emergency room, intravenous loading followed by infusion) with bolus injection during primary PCI of tirofiban, on post-procedural TIMI flow and 30d clinical outcomes. Methods Seven hundred and seven patients with acute STEMI treated by primary PCI in Ruijin hospital were retrospectively and enrolled screened. Among them, 86 patients with single bolus intra-coronary injection of tirofiban (25 μg/kg) during the procedure were served as observation group. Baseline, angiographic, PCI features and rate of major adverse cardiac events (MACE) at 30 d follow-up were compared with those received early intravenous infusion of tirofiban (10ug/kg bolus followed by 0.15μg/(kg·min) intravenous infusion)(control group, n=239). Results Compared with control group, patients in observation group were older[(63.8±11.4) vs. (57.9±8.8), P=0.01], had higher prevalence of hypertension (58.6%vs. 51.0%, P=0.005), multivessel disease (57.0%vs. 34.3%, P<0.001), and female in gender (40.7%vs. 25.1%, P=0.006). Post-procedural TIMI flow in culprit vessel and TMP grade were comparable between the two groups (P=0.66 and P=0.48, respectively). Reduction in TIMI minimal bleeding events were found in the observation group (2.3%vs. 9.6%, P=0.03). MACE free survival rate at 30d clinical follow-up was similar between the two groups (P=0.48). Conclusions Single bolus intra-coronary injection of tirofiban exerts similar effects in post-procedural TIMI flow, TMP grade in culprit vessel and 30d clinical outcomes compared with early use in emergency room with intra-venous loading and infusion, nevertheless, intra-coronary injection resulted in significantly reduced TIMI minimal bleeding events. Prospective, randomized clinical study is mandatory to prove our current results.
ABSTRACT
Objective To evaluate the enhancing effect of MRI with Gd DTPA F(ab)′ 2 in nude mice models with LS 174T tumor, and to investigate the influence of Gd labeling on the immunocompetence of the fragments (ab)′2 of CL 3. Methods (1)Antibodies and tumor models preparation: Monoclonal antibodies (McAb) fragment F(ab)′ 2 against LS 174T colonic adenocarcinoma cell were prepared with hybridoma cell CL 3. Twenty BALB/C nude mice were used as tumor models by subcutaneous injection of LS 174T cells. (2)Gd 3+ Labelling: DTPA anhydride and F(ab)′ 2 fragments were conjugated. Two groups were classified: group A, with C/P=2∶1; group B, with C/P=5∶1. Then, Gd was added into DTPA F(ab)′ 2 solution. Gd DTPA F(ab)′ 2 was formed. Free Gd 3+ and DTPA were removed by dialysis. Purified Gd DTPA F(ab)′ 2 was available. (3) MR scanning techniques: MRI was performed with a GE Signa Horizon LX MR scanner. The nude mice were immobilized and divided into three groups: routine plain scan group, enhanced scan group A(C/P=2∶1)and group B(C/P=5∶1). Results When pH=8.0 ,[F(ab)′ 2]=4.6 mg/ml, and C/P=2∶1 or C/P=5∶1, immuno conjugated rates of group A and B were 74% and 62%, respectively. Immunocompetence of fragment F(ab)′ 2 reduced approximately 12% when C/P increased from 2∶1 to 5∶1.The enhancing effects of two groups of nude mice were both poor, and that of group B(C/P=5∶1) was better than that of group A(C/P=2∶1). Conclusion While C/P increasing, immunocompetence of fragment F(ab)′ 2 reduced, and the enhancing effects of group B was better than group A. The enhancing effect of Gd DTPA F(ab)′ 2 was tumor specific.