Effect Of Thrombus Aspiration Combined With Tirofiban In Coronary Artery For Acute ST Segment Elevation Myocardial Infarction In Primary PCI

Objectives With the continuous improvement of people’s living standard, coronary atherosclerotic heart disease(coronary atherosclerotic heart disease(CAD) yearly incidence continues to rise, coronary heart disease has become one of the disease is a serious threat to human physical and mental health. The prevention and treatment of coronary heart disease in continuous exploration and research, so far there is no clear method can cure. This test is designed to be combined with thrombosis in patients with acute ST underwent emergency percutaneous coronary intervention in elevation myocardial infarction(Thrombus aspiration) aspiration and high-dose tirofiban(Tirofiban) intracoronary infusion with high dose for coronary artery treated with tirofiban in injection without the prior use thrombus aspiration(Thrombus aspiration) for the treatment of postoperative myocardial infarction(thrombolysis in myocardial infarction, TIMI, 24) the blood flow of complete h ST segment, seventh days left ventricular ejection fraction(left ventricular ejection fraction, LVEF), major cardiovascular events in 1 months(major cardiovascular events, MACE) contrast. And on the basis of clinical curative effect and prognosis of combined application of thrombus aspiration and large dose for coronary artery infusion of tirofiban in the treatment of STEMI are discussed and explored.Methods 78 patients with STEMI( ST-elevation myocardial infarction) by emergent PCI(percutaneous coronary intervention) in the emergency internal medicine department of The Second Affiliated Hospital of Medical University Of Anhui in the period from January 2012 to June 2015 were chosen as research subjects, and randomly divided into 2 groups including control group with large dose of tirofiban intracoronary injection(39 cases) and experiment group with large dose of tirofiban intracoronary injection combined with thrombus aspiration operation(39 cases) on the basis of chewing Aspirin(100 mg per tablet) for 3 tablets, clopidogrel(75 mg per tablet) for 4 tablets, atorvastatin statins(20 mg per tablet) for 2 tablets and subcutaneous injection of low molecular weight heparin sodium(4000 I μ) treatment before emergency PCI; the postoperative TIMI grade, postoperative 24 h ST completely fall rate, postoperative 7d left ventricular shoot ejection fraction, the major cardiovascular events after 1 month(death, heart failure, recurrent myocardial infarction, malignant arrhythmia, repeated angina attack etc) of 2 groups were compared. All the data were organized by Excel software and analyzed by SPSS16.0 statistical software in which measurement data was expressed by(X ± S) and the measurement data was compared by t-test while count data was expressed by rate and compared by χ2 test( P <0.05 meaning the statistically significant difference).Results1. The comparison of general data between 2 groupsThere was no statistical significantly difference between 2 groups in general data including the age, gender, family history, smoking history, drinking history, history of hypertension, cerebral infarction, hyperlipidemia, diabetes mellitus, Killip grade of heart function, myocardial infarction, number of stent implantation(P > 0.05)2. The comparison of percentage of blood flow reach to 3 grade after PCI between 2 groupsThe percentage of blood flow reach to 3 grade after PCI of control group and experiment group were separately 62.50%(30/48) and 86.67%(26/30); the percentage of blood flow reach to 3 grade after PCI of experiment group was significant higher than control group(P<0.05).3. The comparison of the complete falling rate of ST segment in 24 h after PCI between 2 groupsThe complete falling rate of ST segment in 24 h after PCI of control group and experiment group were separately 56.25%(27/48) and 80.00%(24/30); the complete falling rate of ST segment in 24 h after PCI of experiment group was significant higher than control group(P<0.05).4. The comparison of the LVEF value in 7d after PCI between 2 groupsThe LVEF value in 7d after PCI of control group and experiment group was separately(42.40%±11.35%),(45.84%±8.12%). The LVEF value in 1 month after PCI of experiment group was significant higher than control group(P<0.05).5. The comparison of the major cardiovascular events in 1 months after PCI between 2 groupsThe major cardiovascular events in 1 months after PCI of control group was 22.92%(11/48)including dead for 1 case, heart failure for 2 cases, recurrent angina for 5 cases, ventricular fibrillation for 2 case and recurrent myocardial infarction for 1 case;The major cardiovascular events in 1 months after PCI of experiment group was separately 16.67%(5/30)including dead for 0 case, heart failure for 1 cases, recurrent angina for 2 cases, ventricular fibrillation for 2 case and recurrent myocardial infarction for 0 case. The major cardiovascular events in 1 months after PCI of experiment group was significant lower than control group(P<0.05).Conclusion Thrombus aspiration combined with Tirofiban in coronary artery for acute ST segment elevation myocardial infarction in primary PCI can Increase myocardial blood supply, Improve cardiac function and after operation.