Evaluation of the clinical efficacy and safety for thrombus aspiration combined with half dose of tirofiban therapy on older patients with STEMI after primary PCI

Objective:To evaluate the clinical efficacy and safety for thrombus aspiration combined with half dose of tirofiban therapy on older patients with acute ST-segment elevation myocardial infarction(STEMI)after primary percutaneous coronary intervention(PCI).Method:Ninety-six older patients with STEMI for primary PCI were randomly divided into two groups:The control group(n=48)was treated with conventional PCI+thrombus aspiration,the observation group(n=48)was treated with conventional PCI+thrombus aspiration+ half dose of tirofiban.Compare the percentage of infarct-related artery(IRA)thrombolysis in myocardial infarction(TIMI)3and TIMI myocardial perfusion grade(TMPG)3,corrected TIMI frame count(CTFC)frames and the incidence of no reflow,CK-MB peak and CK-MB peak time,the percentage of ST segment regression50% within 3hafter PCI,left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDD)at 7dafter PCI,hemorrhage complication within 30 dafter PCI,major adverse cardiovascular events(MACE)within 12 months after PCI.Result:1Coronary angiography at 20 min after the administration of the drug,the percentage of IRA TIMI 3and TMPG 3,CTFC frames and the incidence of no reflow of the observation group were significantly better than that of the control group(P0.05);2The CK-MB peak of the observation group was significantly lower than that of the control group(P0.01),the CK-MB peak time of observation group was significantly shorter than that of control group(P0.01);3The percentage of ST segment regression50% of the observation group was significantly higher than that of the control group(P0.05);4At 7dafter PCI,the LVEF of the observation group was significantly higher than that of the control group(P0.05),and the LVEDD of the observation group was significantly shorter than that of the control group(P0.01);5 Within 30 days,the difference was not statistically significant between two groups on the small amount of bleeding,and no major bleeding occurred in the two groups(P0.05);6Within 12 months after PCI,the MACE occurrence rate of the observation group was significantly lower than that of the control group(P0.05).Conclusion:Thrombus aspiration combined with half dose of tirofiban therapy can improve myocardial perfusion on older patients with STEMI after PCI.It can reduce myocardial injury,improve heart function,reduce MACE.It is safe and with no massive bleeding.