Effects of tirofiban combined with pro urokinase pretreatment on coronary non reflow after PCI in STEMI patients
Objective To investigate the effect of tirofiban combined with recombinant human pro urokinase(rhPro-UK)pretreatment retrograde thrombolysis on coronary non reflow after percutaneous coronary intervention(PCI)in patients with acute ST elevation myocardial infarction(STEMI).Methods 86 STEMI patients admitted to our hospital between May 2021 and February 2023 for PCI treatment were selected.The patients were randomly divided into the control group and the observation group,with 43 cases in each group.Both groups received PCI treatment,with regular heparin sodium and tirofiban administered during surgery,while the control group received routine thrombolysis with rhPro-UK.The observation group received retrograde thrombolysis by injecting rhPro-UK from the distal to the proximal end of the criminal vessel.The blood flow classification,2h ST segment regression rate(STR),coronary no reflow and slow flow(NR/SF)rates in the thrombolysis test for myocardial infarction(TIMI),the incidence of B-type natriuretic peptide(BNP),troponin(cTnI),and left ventricular ejection fraction(LVEF)were compared between the two groups after surgery,and the incidence of TIMI major bleeding events and major adverse cardiovascular events(MACEs)were compared after 3 months of follow-up.Results The TIMI blood flow grading after PCI in the observation group was better than that in the control group,the STR regression rate was higher than that in the control group,and the incidence of NR/SF was lower than that in the control group(P＜0.05);The peak values of BNP and cTnI during postoperative hospitalization in the observation group were lower than those in the control group,while the peak values of LVEF were higher than those in the control group(P＜0.05);During the follow-up period,no TIMI major bleeding occurred in both groups.The incidence of MACEs in the observation group(2 cases of re-hospitalization for heart failure)was lower than that in the control group(1 case of cardiac death and 8 cases of re-hospitalization for heart failure),and the difference was statistically significant(P＜0.05).Conclusion Tirofiban combined with recombinant human pro Urokinase pretreatment retrograde thrombolysis can significantly improve the blood flow reflow and left ventricular ejection function of STEMI patients after PCI,reduce the incidence of coronary non reflow,slow flow and adverse cardiovascular events,and do not increase the risk of bleeding.
TirofibanPro urokinaseRetrograde thrombolysisAcute ST segment elevation myocardial infarctionCoronary regurgitation
万方数据
维普
