Intracoronary injection of tirofiban prevents microcirculation dysfunction during delayed percutaneous coronary intervention in patients with acute myocardial infarction

Sun, Zijie; Zeng, Jianping; Huang, He

doi:10.1016/j.ijcard.2016.01.204

Cited by 9 publications

(4 citation statements)

References 18 publications

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“…In addition, Sun et al [30] found that intracoronary injection of tirofiban prevents microcirculation dysfunction during delayed PCI in AMI patients. Moreover, a meta-analysis showed that compared with intravenous administration of tirofiban, intracoronary administration of tirofiban significantly increased TIMI grade 3 flow (odds ratio [OR] = 2.11; 95% CI 1.02–4.37; P = .04) and TMP grade 3 flow (OR = 2.67; 95% CI 1.09–6.49; P = .03, I 2 = 64%) while reducing the incidence of MACEs (OR = 0.46, 95% CI: 0.28–0.75; P = .002) in ACS patients.…”

Section: Discussionmentioning

confidence: 99%

Effect of intra-coronary administration of tirofiban through aspiration catheter on patients over 60 years with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang

Zhu

et al. 2018

Medicine

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The aim of this study was to compare the efficacy and safety of 2 approaches for intra-coronary administration of tirofiban (aspiration catheter versus guiding catheter) in patients over 60 years of age undergoing percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). It has been suggested that the administration of tirofiban by intra-coronary injection could promote drug absorption in the diseased region and enhance the inhibition of platelet aggregation, decreasing bleeding rates, but little is known about the comparative efficiency and safety of using guiding catheter versus aspiration catheter for delivery.Eighty-nine patients over 60 years of age with STEMI undergoing PCI were randomly divided into 2 groups according to the injection route for intracoronary administration of tirofiban [guiding catheter (n = 41) and aspiration catheter (n = 48)]. Baseline features, epicardial and myocardial perfusion, major adverse cardiac and cerebrovascular events (MACCEs), and bleeding rate were compared.No differences in age, gender, and history of hypertension, hypercholesterolemia, diabetes, and so on were observed (P > .05). The patients in the aspiration catheter group generally had a higher incidence of cerebral vascular disease. Compared with those in the guiding catheter group, patients in the aspiration catheter group obtained more favorable myocardial perfusion (P < .05). In-hospital and at 3-month and 6-month follow-ups, the MACCE rate and frequency of bleeding events were similar between the 2 groups (P > .05).Intra-coronary delivery of tirofiban through aspiration catheter led to better myocardial perfusion in STEMI patients over 60 years of age undergoing PCI compared with intra-coronary injection of tirofiban through guiding catheter. The 2 delivery routes were associated with similar rates of MACCEs and bleeding events.

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Section: Discussionmentioning

confidence: 99%

Effect of intra-coronary administration of tirofiban through aspiration catheter on patients over 60 years with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Wang

Zhu

et al. 2018

Medicine

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“…The half-life of tiro ban is about 2hrs, so the effectiveness can be fast reversed when ceased. As adjunctive antiplatelet treatment for PCI based on dual antiplatelet dual antiplatelet therapy (DAPT), tiro ban is demonstrated to reduce platelet embolization and acute recurrent ischemic events (3,4), prevent microvascular obstruction and the abnormal increase of index of microcirculatory resistance value (5), attenuate in ammatory response (6), improve cardiac impairment, and decrease peri-procedural mortality in ACS patients undergoing PCI. In the 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction, it is reasonable to use high-bolus-dose tiro ban combined with unfractionated heparin in primary PCI, and it may be reasonable to administer upstream GPIIb/IIIa inhibitors before primary PCI (7).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Tirofiban in Patient Undergoing Planned Percutaneous Coronary Intervention Based on Real-world Evidence: A Retrospective Study of 1311 Patients

Huang

Zhu

Zhou

et al. 2022

Preprint

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Background There is no consensus on reductions of ischemic events and bleeding risks of tirofiban for patients receiving planned percutaneous coronary intervention (PCI) yet. In this study, we aim to investigate the real-world efficacy and safety of tirofiban treatment on patients undergoing planned PCI during hospital course and explore potential population who could benefit from tirofiban. Methods This real-world study included 1311 patients who received planned PCI and implanted stents. Demographic and clinical characteristics were compared between patients who received tirofiban treatment (n = 829) and those were not given tirofiban as control (n = 482). Correlation of tirofiban and outcome in hospital level was assessed using logistic regression analysis. Results More tirofiban patients had multivessel disease and multiple stents implantation. On logistic regression analysis, there was no significant association between the usage of tirofiban and bleeding events (OR [95%CI] = 1.36 [0.65,3.06], p = 0.433), major adverse cardiac and cerebrovascular events (MACCE) (OR [95%CI] = 1.37 [0.65, 3.06], p = 0.425) or net adverse cardiac and cerebrovascular events (NACCE) (OR [95%CI] = 1.01 [0.61, 1.71], P = 0.963). In subgroup analysis, tirofiban used among patients with higher D-dimer level (D-dimer ≥ 0.5 g/ml FEU) was less likely to be associated with MACCE (OR = 0.51 vs OR = 4.59, p for interaction = 0.031). Conclusions The use of tirofiban did not decrease MACCE or NACCE during hospital course among patients undergoing planned PCI, however, the risk of bleeding was not increased. Tirofiban receipts were prone to severe illness and complex PCI. Conferring no harm but potential benefits, the use of tirofiban could be considered for patients who received planned PCI and present with comorbidities and complex coronary lesions.

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“…The acute myocardial infarction heads to the ischemic necrosis of the myocardium which is considered to be harmful to the health of the mass population [ 6 ]. The timely widening of the coronary arteries in the patients suffering from the myocardial infraction diminishes the region of myocardial infraction, and there is an outstanding reduction in the mortality rate [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Cardioprotective Action of Glycyrrhizin on Diabetic Rats with Myocardial Remodeling

Chen

Song

2021

Journal of Healthcare Engineering

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Introduction. Cardiovascular disorders are one of the prominent causes of risks of mortality which accounts for high rate of the deaths at a global level. The risk of deadly myocardial infraction grows because of diabetes which even causes the development of heart failure. Objective. The objective of this study was to understand and study the effect of glycyrrhizin on diabetes suffering rats with myocardial remodeling. Materials and Methods. Streptozotocin was used for induction of diabetes, and 8–12 weeks later, the assessment of inflammation, fibrosis, and cardiac damage was evaluated. Histopathological analysis and immunohistochemistry was performed to analyze the effect in various groups. Western blotting was performed to understand the proteins expressed in diabetes, and also, their expression was noted in treatment groups. Results. There was a significant rise in TNF-α, dense fibrosis, and collagen deposits in the STZ diabetes group. The effects of hyperglycemia were significantly improved in the glycyrrhizin-treated group. DAPI, BrDu, and caspase staining was also performed to understand apoptosis in tissues where the diabetic groups reported significant apoptosis, while the effects were significantly lower in the treated group. Conclusion. All the observations indicate that glycyrrhizin has cardioprotective action in diabetic rats with myocardial remodeling and is due to the inhibition of the NF-κB signaling pathway in the myocardial layer.

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Intracoronary injection of tirofiban prevents microcirculation dysfunction during delayed percutaneous coronary intervention in patients with acute myocardial infarction

Cited by 9 publications

References 18 publications

Effect of intra-coronary administration of tirofiban through aspiration catheter on patients over 60 years with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Effect of intra-coronary administration of tirofiban through aspiration catheter on patients over 60 years with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Efficacy and Safety of Tirofiban in Patient Undergoing Planned Percutaneous Coronary Intervention Based on Real-world Evidence: A Retrospective Study of 1311 Patients

Cardioprotective Action of Glycyrrhizin on Diabetic Rats with Myocardial Remodeling

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