Effect of early application of tirofiban on body status of patients with emergency ST segment elevation myocardial infarction after percutaneous coronary intervention

  Objective  To investigate the effect of early application of tirofiban on the inflammatory response, angiography and clinical outcome of patients with emergency ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).

  Methods  Totally 123 STEMI patients with PCI were divided into observation group (n=65) and control group (n=58). The observation group was treated with tirofiban, and the control group was not treated with tirofiban. The levels of serum high sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6) and procalcitonin (PCT) were compared between the two groups at hospital admission and 3 days after treatment. The recovery rate of TIMI grade 3 blood flow, corrected TIMI frame number, incidence rates of ST segment resolution higher than 75% at 90 min after operation, major adverse cardiac events (MACE) at 30 d and bleeding events during hospitalization were compared between the two groups. The influencing factors of MACE were analyzed by univariate and multivariate analysis.

  Results  After 3 days of treatment, hs-CRP, IL-6 and PCT in the observation group were significantly lower than those in the control group (P < 0.05). Compared with the control group, the recovery rate of TIMI grade 3 blood flow of infarction-related vessels in the observation group was significantly higher, the number of corrected TIMI frames was significantly lower, the incidence of ST segment resolution higher than 75% at 90 min after operation was significantly higher, and the incidence rate of MACE at 30 d was significantly lower (P < 0.05). Univariate analysis showed that the prevalence rate of diabetes, Killip cardiac function classification and serum creatinine in the MACE group were significantly higher than those in the non-MACE group, and the systolic blood pressure was significantly lower than that in the non-MACE group (P < 0.05). Multivariate analysis showed that cardiac function classification at admission, systolic blood pressure and early application of tirofiban were independent influencing factors of MACE (P < 0.05).

  Conclusion  Early application of tirofiban can reduce the inflammatory reaction, improve the angiographic and clinical results of emergency STEMI patients with PCI, and it is also an independent factor of MACE.