Application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy

Abstract

Objectives: To investigate the application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy.
 Methods: Two hundred patients with acute ST-segment elevation myocardial infarction (STEMI) complicated with diabetes who underwent percutaneous coronary intervention (PCI) and found to have high thrombus burden in coronary artery admitted to our hospital from September 2018 to September 2020 were selected as subjects, and were divided into two groups according to the randomization method: the intravenous tirofiban bolus group and the intracoronary tirofiban bolus group, with 100 cases in each group. The levels of LVEF, LVESD and LVEDD were detected immediately after admission and 15 days after therapy, and the enzyme-linked immunosorbent assay was utilized to detect the levels of CK-MB, MMP-9 and hs-CRP. Furthermore, the levels of BNP, TNI, CR and UREA of the patients were analyzed, and the levels of ESR and FIB were detected with an automatic blood rheology analyzer to analyze the TIMI classification and the incidence of MACE in the two groups.
 Results: Significant differences were seen between the two groups in the levels of various indicators after therapy. Fifteen days after therapy, the levels of LVEF and LVEDD were higher and the level of LVESD was lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of CK-MB, MMP-9 and BNP in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group (p<0.05); 3d after therapy, the levels of TNI (p<0.05), CR and UREA in the intracoronary tirofiban bolus group were lower than those in the intravenous tirofiban bolus group, with no statistical difference (p>0.05); Similarly, 3d after therapy, the levels of TNI, Cr and Urea, as well as ESR, FIB and hs-CRP were lower in the intracoronary tirofiban bolus group than in the intravenous tirofiban bolus group (p<0.05). Compared with the intravenous tirofiban bolus group, the intracoronary tirofiban bolus group had a lower number of patients with Grade-0 and Grade-1, but a higher number of patients with Grade-2 and Grade-3 (p<0.05); Moreover, the incidence of MACE in the intracoronary tirofiban bolus group was lower than that in the intravenous tirofiban bolus group (p<0.05).
 Conclusion: In patients with STEMI complicated with diabetes who underwent PCI and found to have high thrombus burden in coronary artery, intracoronary bolus of tirofiban boasts superior therapeutic efficacy over intravenous bolus of tirofiban in significantly improving cardiac function, reducing myocardial cell damage, and improving renal function and myocardial inflammation of patients.
 doi: https://doi.org/10.12669/pjms.38.1.4545
 How to cite this:Tang X, Li R, Ma L, Zhang T. Application of tirofiban in patients with acute myocardial infarction complicated with diabetes and undergoing emergency interventional therapy. Pak J Med Sci. 2022;38(1):---------. doi: https://doi.org/10.12669/pjms.38.1.4545
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Correlation between Glycated Haemoglobin Level, Cardiac Function, and Prognosis in Patients with Diabetes Mellitus Combined with Myocardial Infarction

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Clinical study of Edaravone Dexborneol combined with Tirofiban in treatment of Acute Cerebral Infarction

“… 17 Tirofiban is a novel antiplatelet aggregation drug in clinical practice, which can inhibit platelet aggregation by inhibiting platelet membrane glycoprotein IIb/IIIa receptor. 18 Some scholars have pointed out that tirofiban can effectively inhibit platelet aggregation, improve cerebral microcirculation and promote the opening of cerebral collateral circulation in patients with ACI. 19 …”

“…17 Tirofiban is a novel antiplatelet aggregation drug in clinical practice, which can inhibit platelet aggregation by inhibiting platelet membrane glycoprotein IIb/ IIIa receptor. 18 Some scholars have pointed out that tirofiban can effectively inhibit platelet aggregation, improve cerebral microcirculation and promote the opening of cerebral collateral circulation in patients with ACI. 19 The results of our study also showed that the combination of edaravone dexborneol and tirofiban in the treatment of ACI could significantly reduce the levels of inflammatory factors in patients (p< 0.05).…”

Quantitative evaluation of acute myocardial infarction by feature-tracking cardiac magnetic resonance imaging

“…The main pathological changes in acute myocardial infarction (AMI) are acute myocardial ischemia and necrosis. 1 AMIs can be divided into ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) according to ECG findings. 2 Both syndromes are caused by severe coronary artery stenosis or complete occlusion (mainly due to thrombosis on atherosclerotic plaques), and have similar clinical manifestations.…”