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Objective To observe the effect of tirofiban,aspirin and Clopidogrel Hydrogen triple antiplatelet in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention and the effect on the incidence of major adverse cardiac events.Methods a total of 60 patients with acute myocardial infarction(AMI)in our hospital from January 2015 to-2016 in December were enrolled in this study.All patients were treated with percutaneous coronary intervention(PCI).The patients were randomly divided into control group(n=30)and observation group(n=30).The control group using clopidogrel hydrogen treatment,observation group were treated with tirofiban,aspirin and Clopidogrel Hydrogen triple antiplatelet therapy,the incidence and clinical effects of the two groups of major adverse cardiac events.Results the two groups before treatment,the platelet aggregation rate and platelet count had no statistically significant difference; no significant observation group after treatment compared 30d platelet count difference; observation group 30d after treatment,the platelet aggregation rate was lower than the control group(P<0.05); the observation group after the treatment of 30d MA-ADP on platelet drug reaction the inhibition rate is lower than the control group(P<0.05); the observation group after treatment of AA drugs 30d platelet inhibition rate,the inhibition rate of ADP,higher than that of the control group(P<0.05); the observation group after treatment,the incidence of major adverse cardiac events was 13.33％,33.33％in the control group,two groups of major adverse cardiac events was statistically significant the difference(P<0.05).Conclusion The patients with acute myocardial infarction undergoing primary percutaneous coronary intervention after treatment with tirofiban,aspirin and chlorine Pigre triple antiplatelet ideal treatment effect,can reduce the incidence of major adverse cardiac events,it is worthy of popularization and application.
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Objective To evaluate the feasibility and therapeutic efficacy of prophylactic implantation of intraaortic balloon pump in patients with high-risk coronary artery disease.Methods 121 patients with high-risk coronary heart disease who received prophylactic implantation of intraaortic balloon pump in percutaneous coronary intervention were enrolled as the treatment group (Group A),and another 119 patients with high-risk coronary heart disease who had conventional coronary intervention were enrolled as the control group (Group B).The rates of intraoperative malignant arrhythmia (ventricular tachycardia,ventricular fibrillation),acute left heart failure,cardiogenic shock and sudden death were compared between the two group.NT-proBNP levels,left ventricular systolic function and the rates of major adverse cardiac events,within 30 days of PCI and after 1 year were compared between the two groups.Results The event rates of intraoperative malignant arrhythmia,acute left heart failure,cardiogenic shock,and sudden death in Group A was significantly lower than those in Group B (all P ＜ 0.05).Postoperative hematoma were found in 2 cases,aortic dissection in 1 case and thrombocytopenia in 1 case in Group A without significant difference as compared to Group B (P ＞ 0.05).Within 30 days after PCI,NT-proBNP levels and left ventricular diastolic diameter in Group A were lower than those in Group B while the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).The rates of major cardiac adverse events,including sudden cardiac death and severe heart failure were lower than those in Group B (all P ＜ 0.05).At 1 year after PCI,the NT-proBNP levels left ventricular diastolic diameter in Group A were lower than those in Group B with the left ventricular ejection fraction in Group A was higher than that in Group B (all P ＜ 0.05).There were no significant differences in the rates of major cardiac adverse events,including sudden cardiac death and severe heart failure after 1 year(all P ＞ 0.05).Conclusions For patients with high-risk coronary heart disease undergoing coronary intervention,prophylactic implantation of intraaortic balloon pump may decrease the incidence of intraoperative complications,reduce the incidence of cardiac death and severe heart failure within 30 days,and improve the left ventricular function after 1 year.Its role in reducing long term major cardiac adverse events after 1 year still needs more clinical trials for funther justification.
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Objective To evaluate the efficacy of α2 adrenergic agonists for the prevention of postoperative adverse cardiac events in patients with coronary disease.Methods MEDLINE,EMBASE,CINHAL,Web of Science,CBM and CNKI were searched to identify all randomized controlled trials on the efficacy of α2 adrenergic agonists for the prevention of postoperative cardiac complications following operation performed under general anesthesia in patients with coronary artery disease.The incidence of myocardial ischemia,myocardial infarction,bradycardia and hypotension were evaluated.Meta-analysis was conducted using the RevMan 5.1 software.Results Fifteen trials included 9 high-quality trials,4 medium-quality trials and 2 low-quality trials.A total of 3422 patients were included in this meta-analysis.1790 patients received α2 adrenergic agonists (clonidine and dexmedetomidine) and 1632 patients received placebo; 724 patients underwent non-cardiac surgery and 2698 patients underwent cardiac surgery.Meta-analysis indicated that α2 adrenergic agonists reduced incidence of myocardial infarction following non-cardiac surgery and myocardial ischemia following non-cardiac surgery and cardiac surgery.Alpha-2 adrenergic agonists significantly increased the incidence of postoperative bradycardia.Conclusion Alpha-2 adrenergic agonists can decrease postoperative cardiac adverse events in patients with coronary disease,but can induce bradycardia,and the efficacy of clonidine is consistent with that of dexmedetomidine.