Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI
Autor: | Guo-Xiong Chen, Xiao-Xu Yuan, Jin-Lin Zou, Hong-Na Wang |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Ejection fraction business.industry Diastole Infarction 030208 emergency & critical care medicine Tirofiban 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences surgical procedures operative 0302 clinical medicine Internal medicine Conventional PCI cardiovascular system Emergency Medicine medicine Cardiology Original Article cardiovascular diseases Myocardial infarction Nicorandil business TIMI medicine.drug |
Zdroj: | World Journal of Emergency Medicine. 11:157 |
ISSN: | 1920-8642 |
Popis: | Background This study investigated the effects of the intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). Methods Seventy-eight STEMI patients with age >65 years who underwent emergency PCI were consecutively enrolled. These patients received conventional PCI and were randomly divided into a control group and a treatment group (n=39 per group). The control group received an intracoronary injection of tirofiban followed by a maintenance infusion for 36 hours after surgery. The treatment group received intracoronary injection of tirofiban and nicorandil, and then intravenous infusion of tirofiban and nicorandil 36 hours after surgery. The following parameters were measured: TIMI grade, corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG), ST-segment resolution (STR) rate 2 hours post-operatively, resolution of ST-segment elevation (STR) at 2 hours postoperatively, peak level of serum CK-MB, left ventricular end diastolic diameter (LVEDD) and left ventricular ejection fraction (LVEF) at 7-10 days postoperatively, and major adverse cardiac events (MACEs) in-hospital and within 30 days post-operatively. Results Compared with the control group, more patients in the treatment group had TIMI 3 and TMPG 3, and STR after PCI was significantly higher. The treatment group also had significantly lower cTFC, lower infarction relative artery (IRA), lower peak CK-MB, and no reflow ratio after PCI. The treatment group had significantly higher LVEDD and LVEF but lower incidence of MACEs than the control group. Conclusion The intracoronary injection of nicorandil combined with tirofiban can effectively improve myocardial reperfusion in elderly STEMI patients after emergency PCI and improve short-term prognoses. |
Databáze: | OpenAIRE |
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