Clinical research on the early administration of GP Ⅱb/Ⅲa receptor antagonist for reperfusion arrhythmia in STEMI patients with interventional treatment

ObjectiveTo study the efficacy of the early administration of GP Ⅱb/Ⅲa receptor antagonist in the tratment of reperfusion arrhythmia(RA) in acute ST-segment elevation myocardial infarction(STEMI) patients treated with emergency percutaneous coronary intervention(PCI).

MethodsNinety STEMI patients treated with emergency PCI were randomly divided into the observation group(45 cases treated with tirofiban injection intravenously immediately after admission) and control group(45 cases treated with tirofiban injection during PCI).The TIMI blood flow before and after PCI, percentage of ST segment drop after 90 min of PCI and occurrence of RA were compared between two groups.

ResultsThe time from tirofiban to balloon dilation in observation group(55.70±16.81) min was significantly shorter than that in control group(3.70±0.72) min (t=22.73, P < 0.01).The total amount of tirofiban use in the observation group and control group was (11.82±2.68) mg and (10.75±2.74) mg, respectively, and the difference of which was not statistically significant(t=1.87, P>0.05).There was no statistical significance in the number of coronary artery lesions and target vessel position between two groups(P>0.05).The results of preoperative coronary angiography showed that the TIMI blood flow of infarct related vessels in the observation group was significantly improved compared with that in the control group(P < 0.01).There were 6 cases with level 2 and 3 TIMI blood flow in the control group and 15 cases with level 2 and 3 TIMI blood flow in the observation group, and the difference of which was statistically significant(P < 0.05).After PCI, 43 cases with level 3 TIMI in the observation group and 35 cases with level 3 TIMI in the control group were found, and the difference of which was statistically significant(P < 0.05).Compared with the control group, the ST segment in the observation group decreased significantly within 90 min, and the difference of which between two groups was statistically significant(P < 0.05).The total incidence rate of RA in the observation group was significantly lower than that in the control group(P < 0.01), and the incidence rate of severe arrhythmia in the observation group was significantly lower than that in the control group(P < 0.01).

ConclusionsThe early administration of GP Ⅱb/Ⅲa receptor antagonist in STEMI patients can significantly improve the RA during PCI and myocardial reperfusion.