Evaluation of the effects of tirofiban on myocardial infarction-reperfusion injury by delayed enhancement multi-slice spiral CT / 中华放射学杂志

ABSTRACT

Objective To evaluate the effcets of tirofihan on myocardial no-reflow after acute myocardial infarction and reperfusion by delayed enhancement-multi-slice CT(DE-MSCT).Methods Chinese mini pigs were randomized into control group and firofiban treatment group. Acute myocardial infarction was induced by balloon occlusion of the medium segment of the left anterior descending artery for 90 minutes. Repeffusion was created by withdrawing the balloon during angiography. All successful models received DE-MSCT examinatons at 1 h, 24 h, 48 h, and 72 h after reperfusion to observe the myocardial noreflow area. Data were analyzed with Spearman rank correlation and Wilcoxon Rank Sum test. Results Six pigs were successfully induced as acute reperfusion myocardial infarction in each group. Furthermore,4 pigs in control group and 3 pigs in firofiban treatment group had no-reflow phenomenon. The no-reflow volume percent increased from 1 h to 72 h in both groups. The no-reflow volume percent was significantly reduced in tirofiban treatment group compared with control group after reperfusion at 1 h, 24 h, 48 h and 72 h respectively[(4.78±0.66)% and (9.62±3.05)%, t =6.000, P＜0.05; (5.84 ± 1.19)% and (13.44±3.33)% ,t=6.000,P＜0. 05;(6.41± 1.24)% and (15.10±3.76)%,t =6.000,P ＜0.05;(6.63 ±0. 82)% and (15.94 ±4.62)% ,t =6.000,P ＜0.05] ,as well as the infarct myocardium volume percent was significantly reduced in tirofiban treatment group compared with control group at 24 h, 48 h and 72 h after reperfusion [ (19.74± 2. 94) % and ( 25.08 ± 4.68) %, t = 25.000, P ＜ 0.05;(20.34±2.46) % and (27.07 ±5.44)%, t =26. 000,P ＜0.05; (20.72 ±2.10)% and (26.17 ±5.19)% ,t = 24.000,P ＜0.05]. Conclusions DE-MSCT can be used to detect the extent of no-reflow phenomenon. Tirofiban can reduce the volume of myocardial infarct and no-reflow area after reperfusion.