| Autor: |
Igor Matos Lago, Gustavo Caires Novaes, André Vannucchi Badran, Rafael Brolio Pavão, Ricardo Barbosa, Geraldo Luiz de Figueiredo, Moysés de Oliveira Lima Filho, Jorge Luiz Haddad, André Schmidt, José Antônio Marin Neto |
| Jazyk: |
English<br />Portuguese |
| Předmět: |
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| Zdroj: |
Arquivos Brasileiros de Cardiologia, Vol 107, Iss 5, Pp 403-410 |
| Druh dokumentu: |
article |
| ISSN: |
1678-4170 |
| DOI: |
10.5935/abc.20160149 |
| Popis: |
Abstract Background: Despite successful opening of culprit coronary artery, myocardial reperfusion does not always follows primary percutaneous coronary intervention (PPCI). Glycoprotein IIb/IIIa inhibitors are used in the treatment of no-reflow (NR), but their role to prevent it is unproven. Objective: To evaluate the effect of in-lab administration of tirofiban on the incidence of NR in ST-elevation myocardial infarction (STEMI) treated with PPCI. Methods: STEMI patients treated with PPCI were randomized (24 tirofiban and 34 placebo) in this double-blinded study to assess the impact of intravenous tirofiban on the incidence of NR after PPCI according to angiographic and electrocardiographic methods. End-points of the study were: TIMI-epicardial flow grade; myocardial blush grade (MBG); resolution of ST-elevation < 70% (RST < 70%) at 90min and 24h after PPCI. Results: Baseline anthropometric, clinical and angiographic characteristics were balanced between the groups. The occurrence of TIMI flow < 3 was not significantly different between the tirofiban (25%) and placebo (35.3%) groups. MBG ≤ 2 did not occur in the tirofiban group, and was seen in 11.7% of patients in the placebo group (p=0.13). RST < 70% occurred in 41.6% x 55.8% (p=0.42) at 90min and in 29% x 55.9% (p=0.06) at 24h in tirofiban and placebo groups, respectively. Severe NR (RST ≤ 30%) was detected in 0% x 26.5% (p=0.01) at 90 min, and in 4.2% x 23.5% (p=0.06) at 24h in tirofiban and placebo groups, respectively. Conclusion: This pilot study showed a trend toward reduction of NR associated with in-lab upfront use of tirofiban in STEMI patients treated with PPCI and paves the way for a full-scale study testing this hypothesis. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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