Effects Of Intracoronary Tirofiban And Nitroprussid Injection On The No-reflow Penomenon During Emergency Percutaneous Coronary Intervention

Objective: The aim of this study was to observe the effect of intracoronary injections of nitroprusside and tirofiban on no-reflow phenomenon during percutaneous coronary intervention.Methods: A total of 78 patients with acute STEMI who underwent emergency PCI and thrombus aspiration in our hospital from January 2015 to December 2016 were chosen and randonly divided into two group,tirofiban group in which 39 cases were administered with tirofiban only,combined medication group in which 39 cases were administered with tirofiban and nitroprussid.The TIMI(thrombolysis in myocardial infarction)flow grade,corrected TIMI frame count(CTFC),TIMI myocardial perfusion grade(TMPG),ST segment resolution rate,peak value of blood CK-MB and cTnI,left ventricular end diastolic volume(LVEDD),left ventricular ejection fraction(LVEF),perioperative hemorrhagic complication and major adverse cardiac events(MACE)in a month after discharge were also recorded and compared.Results:1.The percentage of TIMI3 blood flow and TMPG in combined medication group were significantly higher than those in tirofiban group,whereas the CTFC,cTnI,CK-MB and the rate no reflow phenomenon in combined medication group were all significantly lower than those in tirofiban group(P<0.05).2.The ST-segment resolution rate,LVEF and LVEDD were also tended better in combined medication group than tirofiban group(P>0.05).3.The incidence of major adverse cardiac events and complications were similar between the 2 groups(P>0.05).Conclusions: Compared with the injection of tirofiban alone,combined intra-coronary of tirofiban and nitroprusside can reduce the incidence rate of the no reflow phenomenon,improve the left ventricular function,without increasing the incidence rate of major adverse cardiac events and complications in hospital and follow-up within 30 days.