Therapeutic effect of PCI combined tirofiban hydrochloride on aged ASTEMI patients and its influence on cardiac function and myocardial microcirculation indexes / 心血管康复医学杂志

ABSTRACT

Objective:To explore therapeutic effect of percutaneous coronary intervention(PCI)combined tirofiban hydrochloride on aged patients with acute ST elevation myocardial infarction(ASTEMI)and its influence on cardiac function and myocardial microcirculation.Methods:A total of 90 aged ASTEMI patients undergoing PCI in our hospital from Jul 2013 to Mar 2016 were selected.According to hospitalization order,they were randomly and e-qually divided into pure PCI group and combined treatment group(received tirofiban based on pure PCI group), both groups were treated for one month.ST segment regression degree,corrected TIMI frame count(CTFC)and TIMI flow grade after PCI,contrast agent acoustic peak intensity in myocardial microcirculation(PI)and serum CK-MB peak concentration before and after PCI,LVEF,LVEDd and LVEDV before and six months after PCI, and incidence rate of adverse events were measured and compared between two groups.Results:Compared with pure PCI group after PCI,there were significant rise in ST segment regression degree[(43.8 ± 7.1)% vs.(66.2 ± 8.2)%],TIMI flow grade[(2.1 ± 0.5)grade vs.(2.9 ± 0.6)grade]and PI[(7.1 ± 1.1)vs.(8.6 ± 1.2)],and sig-nificant reductions in CTFC[(27.3 ± 8.0)frame vs.(18.9 ± 6.6)frame],and serum CK-MB peak level[(296.5 ± 58.1)U/L vs.(199.3 ± 32.4)U/L]in combined treatment group,P= 0.001 all.Compared with pure PCI group on six months after PCI,there was significant rise in LVEF[(54.2 ± 8.3)% vs.(61.1 ± 8.0)%],and signifi-cant reductions in LVEDd[(48.1 ± 7.7)mm vs.(41.3 ± 8.1)mm]and LVEDV[(85.4 ± 10.6)mm3vs.(80.2 ± 10.4)mm3]in combined treatment group,P<0.05 or <0.01.Total incidence rate of adverse events of com-bined treatment group was significantly lower than that of pure PCI group(8.89% vs.26.67%),P=0.001.Con-clusionPCI combined tirofiban hydrochloride can significantly improve myocardial microcirculation and cardiac function with low incidence rate of cardiovascular adverse events.The mechanism may be related to improving effect of tirofiban hydrochloride on myocardial microcirculation.