Skip to main content
Erschienen in: Herz 3/2020

12.06.2018 | Original articles

Myocardial reperfusion with tirofiban injection via aspiration catheter

Efficacy and safety in STEMI patients with large thrombus burden

verfasst von: Z. Zhang, W. Li, W. Wu, Q. Xie, J. Li, W. Zhang, Y. Zhang

Erschienen in: Herz | Ausgabe 3/2020

Einloggen, um Zugang zu erhalten

Abstract

Background

There is no consensus on the use of thrombus aspiration (TA) in primary percutaneous coronary intervention (PPCI), and few studies have focused on the performance of tirofiban via TA catheter after PPCI. Our study investigated the clinical outcome of tirofiban injection through TA in acute ST-segment elevation myocardial infarction (STEMI) patients with large thrombus burden undergoing PPCI treatment.

Patients and methods

The study comprised 122 STEMI patients who underwent TA during PPCI. Participants were randomly divided into two groups. Group A received intravenous tirofiban injection and tirofiban injection via a TA catheter to the infarcted coronary artery after aspiration (n = 61). Group B received intravenous tirofiban injection only (n = 61). Baseline clinical information and follow-up data were collected for both groups. Coronary angiography, electrocardiography, and echocardiography findings as well as major adverse cardiovascular events (MACE) were recorded.

Results

There were significant differences in postprocedural Thrombolysis in Myocardial Infarction (TIMI) grade 2 and 3 flow between the two groups (p = 0.021, p = 0.006, respectively). The incidence of slow-flow in group A was significantly lower than that of group B (p = 0.011). An increased incidence of no ST-segment resolution was observed in group B (p = 0.011). There were fewer major adverse cardiovascular events in group A than in group B, but the difference was not statistically significant.

Conclusion

Selective tirofiban injection via TA catheter during PPCI may improve myocardial reperfusion in STEMI patients with large thrombus burden.
Literatur
1.
Zurück zum Zitat Levine GN, Bates ER, Blankenship JC et al (2016) 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. J Am Coll Cardiol 67(10):1235–1250. https://doi.org/10.1016/j.jacc.2015.10.005 CrossRefPubMed Levine GN, Bates ER, Blankenship JC et al (2016) 2015 ACC/AHA/SCAI Focused Update on Primary Percutaneous Coronary Intervention for Patients With ST-Elevation Myocardial Infarction: An Update of the 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention and the 2013 ACCF/AHA Guideline for the Management of ST-Elevation Myocardial Infarction. J Am Coll Cardiol 67(10):1235–1250. https://​doi.​org/​10.​1016/​j.​jacc.​2015.​10.​005 CrossRefPubMed
2.
Zurück zum Zitat Olsen EA, Whittaker S, Kim YH et al (2011) Clinical end points and response criteria in mycosis fungoides and Sezary syndrome: a consensus statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer. J Clin Oncol 29(18):2598. https://doi.org/10.1200/JCO.2010.32.0630 CrossRefPubMedPubMedCentral Olsen EA, Whittaker S, Kim YH et al (2011) Clinical end points and response criteria in mycosis fungoides and Sezary syndrome: a consensus statement of the International Society for Cutaneous Lymphomas, the United States Cutaneous Lymphoma Consortium, and the Cutaneous Lymphoma Task Force of the European Organisation for Research and Treatment of Cancer. J Clin Oncol 29(18):2598. https://​doi.​org/​10.​1200/​JCO.​2010.​32.​0630 CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Gao L, Cao Z, Zhang H (2016) Efficacy and safety of thrombectomy combined with Intracoronary administration of tirofiban in ST-segment elevation myocardial infarction (STEMI). Med Sci Monit 22:2699–2705CrossRef Gao L, Cao Z, Zhang H (2016) Efficacy and safety of thrombectomy combined with Intracoronary administration of tirofiban in ST-segment elevation myocardial infarction (STEMI). Med Sci Monit 22:2699–2705CrossRef
8.
Zurück zum Zitat Chen Y, Zhou P, Yan H et al (2013) Impact of selective infarct-related artery infusion of tirofiban on myocardial reperfusion and bleeding complications in patients with acute myocardial infarction: the SUIT-AMI trial. J Invasive Cardiol 25(8):376–382PubMed Chen Y, Zhou P, Yan H et al (2013) Impact of selective infarct-related artery infusion of tirofiban on myocardial reperfusion and bleeding complications in patients with acute myocardial infarction: the SUIT-AMI trial. J Invasive Cardiol 25(8):376–382PubMed
9.
Zurück zum Zitat Sianos G, Papafaklis MI, Serruys PW (2010) Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. J Invasive Cardiol 22(10 Suppl B):6b–14bPubMed Sianos G, Papafaklis MI, Serruys PW (2010) Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. J Invasive Cardiol 22(10 Suppl B):6b–14bPubMed
10.
Zurück zum Zitat Kushner FG, Hand M, Smith SC Jr. et al (2009) 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 54(23):2205–2241. https://doi.org/10.1016/j.jacc.2009.10.015 CrossRefPubMed Kushner FG, Hand M, Smith SC Jr. et al (2009) 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 54(23):2205–2241. https://​doi.​org/​10.​1016/​j.​jacc.​2009.​10.​015 CrossRefPubMed
Metadaten
Titel
Myocardial reperfusion with tirofiban injection via aspiration catheter
Efficacy and safety in STEMI patients with large thrombus burden
verfasst von
Z. Zhang
W. Li
W. Wu
Q. Xie
J. Li
W. Zhang
Y. Zhang
Publikationsdatum
12.06.2018
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 3/2020
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-018-4716-0

Weitere Artikel der Ausgabe 3/2020

Herz 3/2020 Zur Ausgabe

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

„Jeder Fall von plötzlichem Tod muss obduziert werden!“

17.05.2024 Plötzlicher Herztod Nachrichten

Ein signifikanter Anteil der Fälle von plötzlichem Herztod ist genetisch bedingt. Um ihre Verwandten vor diesem Schicksal zu bewahren, sollten jüngere Personen, die plötzlich unerwartet versterben, ausnahmslos einer Autopsie unterzogen werden.

Hirnblutung unter DOAK und VKA ähnlich bedrohlich

17.05.2024 Direkte orale Antikoagulanzien Nachrichten

Kommt es zu einer nichttraumatischen Hirnblutung, spielt es keine große Rolle, ob die Betroffenen zuvor direkt wirksame orale Antikoagulanzien oder Marcumar bekommen haben: Die Prognose ist ähnlich schlecht.

Schlechtere Vorhofflimmern-Prognose bei kleinem linken Ventrikel

17.05.2024 Vorhofflimmern Nachrichten

Nicht nur ein vergrößerter, sondern auch ein kleiner linker Ventrikel ist bei Vorhofflimmern mit einer erhöhten Komplikationsrate assoziiert. Der Zusammenhang besteht nach Daten aus China unabhängig von anderen Risikofaktoren.

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.