| Objective To investigate effects of platelet glycoproteinⅡb/Ⅲa inhibitor tirofiban on left ventricular remodeling and clinical outcomes in patients with acute myocardial infarction(AMI) who received primary percutaneous coronary intervention(PCI).Methods 1 Groups Eighty-five AMI patients on admission in emergency room were to be selected. The patients who were coagulation disorders, thrombocytopenia, and had intracranial bleeding, recent bleeding, received thrombolytic therapy, contrast agent allergy, and that do not agree with interventional treatment are excluded. While PAMI score as independent predictive factors, and as a score indicator, the patients whose score≥9 points are to be selected. According to the treatment the patients were randomly divided into the conventional therapy(control group, n=40) and on the basis of conventional therapy with tirofiban(observation group, n=45).2 Medication Apply Tirofiban before transplanting stents in treatment group in emergency room, loading dose is lOug/kg, intravenous injection within three minutes, the dose is decreased to half to the age＞70 or renal inadequacy patients, then last for 36 hours intravenous drip by 0.15ug/kg/min maintenance dose. After surgery, all the patients were sent into care unit. 3 Observation indicatrix We evaluated the LV ejection fraction(LVEF), LV end-diastolic volume index (LVEDVI), LV end-systolic volume index(LVESVI) and left ventricular end-diastolic dimension(LVEDD) of each patient by echocardiography at the time of admission and at 30 day after the onset of the AMI. Clinical observation indicatrix, major adverse cardic events in hospital(Non-fatal myocardial re-infarction, restruct criminal vessel, cardiac death), heart failure, shock. Bleeding(brain bleeding, gingival bleeding, major bleeding, minor bleeding) and thrombocytopenia. Following 30 days after surgery, comprehend the situation(myocardial re-infarction, heart failure, cardiac death).Results 1 Two groups on the effects of cardiac remodeling is not statistically significance at the 1 day, but it can be found there are significant differences in LVEF, LVEDD, LVEDVI, LVESVI and LVMI in experimental group at the 30 day (P＜0.05).2 And the MACE rates are significantly reduced in tirofiban group. But there is not discrepant in the rate of bleeding.Conclusion 1 Tirofiban treatment can improve the blood perfusion and microcirculation disfunction, aviod further myocardial cell death, thus delay the process of the evolution of left ventricular remodeling.2 Tirofiban can reduce the incidence rate of MACE in AMI patients.3 The application of Tirofiban in AMI patients treated by PCI is safe, thereby enhance the patient's clinical outcomes in the near future.
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