Effect analysis of different doses of tirofiban in emergency PCI in elderly patients with acute STEMI
Objective To investigate the practical effect of different doses of tirofiban in emergency percutaneous coronary intervention(PCI)in elderly patients with acute ST elevation myocardial infarction(STEMI).Methods 100 elderly patients with acute STEMI who underwent emergency PCI were selected for this study,and the patients were randomly divided into a reference group and a study group,with 50 cases in each group.The reference group was treated with standard dose of tirofiban[0.15 μg/(kg·min)pumped continuously intraoperatively and 36 h postoperatively],while the study group was treated with 1/2 dose of tirofiban[0.075 μg/(kg·min)pumped continuously intraoperatively and 36 h postoperatively].The myocardial perfusion level,myocardial injury and major adverse cardiovascular events(MACE)were compared between the two groups after treatment.Results The MACE incidence rate of 4.00%(2/50)in the study group was significantly lower than that of 16.00%(8/50)in the reference group(χ2=4.000,P=0.046<0.05).In the study group,the troponin T(cTnT),creatine kinase isoenzyme(CK-MB)and heart fatty acid-binding protein(hFABP)were(5.23±0.49)µg/L,(110.66±13.26)U/L and(11.46±1.68)ng/ml before treatment,and(1.89±0.64)µg/L,(64.97±5.56)U/L and(4.21±0.39)ng/ml after treatment,respectively.In the reference group,cTnT,CK-MB and hFABP were(5.20±0.37)µg/L,(111.61±11.64)U/L and(12.06±1.49)ng/ml before treatment,and(1.92±0.57)µg/L,(65.71±6.29)U/L and(4.31±0.44)ng/ml after treatment,respectively.The levels of cTnT,CK-MB and hFABP in both groups after treatment were lower than those before treatment(P<0.05).There were no significant differences in cTnT,CK-MB and hFABP levels between the two groups(P>0.05).After treatment,there were no differences in thrombolysis in myocardial infarction(TIMI)blood flow classification,corrected TIMI frame count(CTFC),incidence of slow coronary flow(SCF)and ST segment depression between the two groups(P>0.05).Conclusion Standard dose and 1/2 dose of tirofiban have similar effects on improving myocardial perfusion and myocardial injury in elderly acute STEMI patients undergoing emergency PCI.However,the use of 1/2 dose tirofiban can reduce the incidence of MACE in patients and has certain clinical significance.
TirofibanAcute ST elevation myocardial infarctionPercutaneous coronary intervention therapyMyocardial perfusionMyocardial injury
NETL
NSTL
万方数据
维普
