Dose-related outcome of intracoronary tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention

Background Increasing studies were designed to administer a low beneficial outcomes. However, the appropriate dose via coronary for intervention with acute ST-segment elevation myocardial infarction bolus of intracoronary tirofiban to achieve patients undergoing percutaneous coronary （STEMI） is needed to be investigated. Methods Eighty three patients with STEMI presented within 12 hrs of symptoms were randomly allocated to high-dose group （n = 28）, low-dose group （n = 35） and control group （n = 30）. The culprit vessels were targeted with primary PCI in all patients. Clinical characteristics, angiographic findings, brain natriuretic peptide （BNP） at 7-day and in-hospital outcomes were compared among groups, as well as left ventricular ejection fraction （LVEF） and major adverse cardiac events （MACE） at 30-day clinical follow-up. Results High-dose and low-dose groups showed better thrombolysis in myocardial infarction （TIMI） flow grades immediately after PCI （P = 0.02） and lower incidence of the 30-day composite major cardiac adverse events than the control group, but there was not significant difference between high-dose and low-dose group. The LVEF and BNP in the studied groups at 7 days were better than those in the control group （P = 0.04 and P = 0.04, respectively）. No significant difference in hemorrhagic complications in hospital between groups were noted （P = 0.76）. Conclusions Intracoronary bolus administration of tirofiban for patients with STEMI undergoing primary PCI can improve the reperfusion level in the infarcted area and clinical outcomes in 30-day follow-up. It is superior to intravenous bolus injection for improving coronary flow, LVEF and short-term clinical outcomes. However, increasing dose of intracoronary tirofiban doesn＇t show significant differences.