Aspiration thrombectomy and intracoronary tirofiban in ST-segment elevation myocardial infarction: Combination treatment for patients undergoing primary percutaneous coronary intervention

• Published in: Herz 2016-12, Vol.41 (8), p.732-740
• Main Authors: Geng, T., Zhang, J.-G., Song, Z.-Y., Dai, S.-P., Luo, Y., Xu, Z.-S.
• Format: Article
• Language: English
• Subjects: Cardiology; China - epidemiology; Combined Modality Therapy - mortality; Combined Modality Therapy - utilization; Female; Fibrinolytic Agents - administration & dosage; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Original Articles; Percutaneous Coronary Intervention - mortality; Percutaneous Coronary Intervention - utilization; Prevalence; Risk Factors; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - mortality; ST Elevation Myocardial Infarction - therapy; Survival Rate; Thrombectomy - mortality; Thrombectomy - utilization; Treatment Outcome; Tyrosine - administration & dosage; Tyrosine - analogs & derivatives
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-016-4426-4

Aim Primary percutaneous coronary intervention is the most effective treatment for patients with ST-segment elevation myocardial infarction (STEMI). This study aimed to investigate whether the combination of aspiration thrombectomy with intracoronary tirofiban treatment can result in smaller infarcts and better patient prognosis compared with aspiration thrombectomy alone. Patients and methods In all, 150 patients with STEMI underwent primary percutaneous coronary intervention. Group A received aspiration thrombectomy and group B received a combination treatment of aspiration thrombectomy with intracoronary tirofiban. The endpoint was major adverse cardiovascular events, including myocardial (re)infarction, cardiovascular death, and target vessel revascularization. Results The clinical characteristics of the groups were not significantly different ( p >  0.05). The percentage of patients whose thrombolysis in myocardial infarction (TIMI) myocardial perfusion grades were less than 3 was significantly higher for group B than for group A (13.9 vs. 3.8 %, p  = 0.029). The infarct size on cardiac magnetic resonance imaging was significantly different between groups ( p  = 0.036). At 6 months after the operation, the echocardiography results were better for patients in group B than for those in group A ( p  = 0.024 and p  = 0.016, respectively). The frequency of bleeding complications and major adverse cardiac events of the groups were not significantly different ( p >  0.05). Conclusion Aspiration thrombectomy with intracoronary tirofiban in patients with STEMI is safe and effective. For cases with a large angiographic thrombus burden, tirofiban did not increase the rate of bleeding complications or major adverse cardiovascular events.