急性ST段抬高心肌梗死直接PCI后替罗非班应用时间对中期临床预后的影响

目的 评价急性ST段抬高心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)后应用替罗非班时间对中期临床预后的影响.方法 选择50例急性STEMI患者入院后即刻接受、替罗非班治疗,直接PCI后随机分为两组:短时间组(STG,PCI后替罗非班继续使用24～36 h)29例和长时间组(LTG,PCI后替罗非班继续使用48-72 h)21例.记录两组患者随访6个月内主要心脏不良事件和术后6个月复查冠状动脉造影结果.结果 LTG患者随访期间顽固性心绞痛的发生率为14.3%,明显低于STG患者的24.1%(P<0.05),但两组的再狭窄率比较差异无统计学意义.结论 急性STEMI患者急诊直接PCI后较长时间应用替罗非班可减少顽固性心绞痛的发生,改善中期临床预后.

Effects of tirofiban application time on middle-term clinical prognesis in patients with acute ST segment elevation myocardial infarction treated by primary percutaneous coronary intervention

Objective To investigate the effects of tirofiban application time on middle-term clinical prognosis in patients with acute ST segment elevation myocardial infarction (STEMI)treated by primary percutsneous coronary intervention (PCI). Methods The study of tirofiban was carried out in 50 patients with STEMin cardiology department from January to December 2006. Twenty-nine patients were randomized to receive tirofiban after PCI for 24 - 36 hours(short time group, STG) and 21 patients for 48 - 72 hours (long time group,LTG). Clinical characteristics, angiography data, main adverse cardiovascular events (MACE) and coronary restenosis rate in 6-month follow-up of the two groups were. compared. Results Follow-up data showed that there was less intractable angina pectoris (14.3% vs 24.1%, P< 0.05) in LTG. But there was no significant difference in coronary restenosis rate between two groups. Conclusion Long time application of tirofiban following PCI in patients with STEMI could improve middle-term clinical prognosis by alleviating the incidence of intractable angina pectoris.