RESUMO
Objective To observe the effects of antiplatelet drugs on the incidence of no reflow,main adverse cardiovascular and cerebrovascular events (MACCE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD).Methods From January 2010 to February 2011,a total of 84 CHD patients with no-reflow after PCI were selected and randomly divided into observed group and control group (n=42 each group).Patients with no/slow-reflow in observed group were injected with tirofiban through coronary artery with a guiding catheter.If invalid,patients were injected with tirofiban by catheterization again with a micro-pump continuous pumping for 24 h.Patients with no/slow reflow in control group were injected with verapamil by catheterization.If invalid,patients were injected with verapamil by catheterization again.Results The numbers of patients with Thrombolysis in Myocardial Infarction (TIMI) 3 in the first and last angiography after drug administration were much more in observed group than in control group [26 cases (61.9％) vs.17 cases (40.5％),35 cases (83.3％) vs.23 cases (54.8％),respectively,x2 =3.86,8.02,both P＜0.05].The first TIMI frame count (TFC) after drug administration was significantly lower in observed group than in control group,and the difference between groups became larger in the last TFC (t=-3.44,-12.41,both P＜0.05).The number of patients with TIMI myocardial perfusion grade (TMPG) 3 in the first and last angiography after drug administration were much more in observed group than in control group [24 cases (57.1％) vs.13 cases (31.0％),31 cases (73.8％) vs.20 cases (47.6％),respectively,x2=5.84,6.04,both P＜0.05].After 60 days of follow up,there was a significant difference in the incidence of endpoint events between observed and control group [23.8％ (10 cases) vs.52.3％ (12 cases),x2 =7.27.P＜0.01].The predisposing factors of no reflow were age,acute myocardial infarction (AMI),diabetes,hyperlipidemia and hypertension.Conclusions Tirofiban can effectively and safely reduce the incidence of no-reflow after percutaneous coronary intervention in patients with CHD.
RESUMO
Objective To analyze the clinical effect and complication of trans-radial and femoral artery for percutaneous coronary intervention (PCI) in patients with coronary heart disease.Methods Totally 153 patients with coronary heart disease undergoing PCI were divided into radial artery and femoral artery groups.X-ray exposure time,operation time,the success rates of puncture and operation,in-bed time and complication were recorded. Results There were no significant differences in X-ray exposure time[(17±5)min vs.(16±6)min,t=0.61,P=0.57],operation time [(49± 9) min vs. (48 ± 11) min,t=0.59,P =0.61],the success rates of puncture (98.7％ vs.100.0％,x2 =0.47,P=0.53) and operation (96.0％ vs.96.2％,x2 =0.14,P=0.64) between radial artery and femoral artery groups.However,the complication rates was higher in femoral artery group than in radial artery group (17.9％ vs.2.7 ％,x2 =9.54,P=0.002),in-bed time was shorter in radial artery group than in femoral artery group [(4.5 ± 1.2)h vs.(13.2 ±4.6)h,t=2.12,P =0.003]. Conclusions The trans-radial artery PCI is safe,effective and feasible,with less complications and shorter in-bed time.