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Effect of intra-coronary administration of tirofiban through aspiration catheter on patients over 60 years with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

Abstract The aim of this study was to compare the efficacy and safety of 2 approaches for intra-coronary administration of tirofiban (aspiration catheter versus guiding catheter) in patients over 60 years of age undergoing percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). It has been suggested that the administration of tirofiban by intra-coronary injection could promote drug absorption in the diseased region and enhance the inhibition of platelet aggregation, decreasing bleeding rates, but little is known about the comparative efficiency and safety of using guiding catheter versus aspiration catheter for delivery.Eighty-nine patients over 60 years of age with STEMI undergoing PCI were randomly divided into 2 groups according to the injection route for intracoronary administration of tirofiban [guiding catheter (n = 41) and aspiration catheter (n = 48)]. Baseline features, epicardial and myocardial perfusion, major adverse cardiac and cerebrovascular events (MACCEs), and bleeding rate were compared.No differences in age, gender, and history of hypertension, hypercholesterolemia, diabetes, and so on were observed (P > .05). The patients in the aspiration catheter group generally had a higher incidence of cerebral vascular disease. Compared with those in the guiding catheter group, patients in the aspiration catheter group obtained more favorable myocardial perfusion (P < .05). In-hospital and at 3-month and 6-month follow-ups, the MACCE rate and frequency of bleeding events were similar between the 2 groups (P > .05).Intra-coronary delivery of tirofiban through aspiration catheter led to better myocardial perfusion in STEMI patients over 60 years of age undergoing PCI compared with intra-coronary injection of tirofiban through guiding catheter. The 2 delivery routes were associated with similar rates of MACCEs and bleeding events.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29794782
OWN - NLM
STAT- MEDLINE
DCOM- 20180604
LR  - 20180604
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 21
DP  - 2018 May
TI  - Effect of intra-coronary administration of tirofiban through aspiration catheter 
      on patients over 60 years with ST-segment elevation myocardial infarction
      undergoing percutaneous coronary intervention.
PG  - e10850
LID - 10.1097/MD.0000000000010850 [doi]
AB  - The aim of this study was to compare the efficacy and safety of 2 approaches for 
      intra-coronary administration of tirofiban (aspiration catheter versus guiding
      catheter) in patients over 60 years of age undergoing percutaneous coronary
      intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). It has
      been suggested that the administration of tirofiban by intra-coronary injection
      could promote drug absorption in the diseased region and enhance the inhibition
      of platelet aggregation, decreasing bleeding rates, but little is known about the
      comparative efficiency and safety of using guiding catheter versus aspiration
      catheter for delivery.Eighty-nine patients over 60 years of age with STEMI
      undergoing PCI were randomly divided into 2 groups according to the injection
      route for intracoronary administration of tirofiban [guiding catheter (n = 41)
      and aspiration catheter (n = 48)]. Baseline features, epicardial and myocardial
      perfusion, major adverse cardiac and cerebrovascular events (MACCEs), and
      bleeding rate were compared.No differences in age, gender, and history of
      hypertension, hypercholesterolemia, diabetes, and so on were observed (P &gt; .05). 
      The patients in the aspiration catheter group generally had a higher incidence of
      cerebral vascular disease. Compared with those in the guiding catheter group,
      patients in the aspiration catheter group obtained more favorable myocardial
      perfusion (P &lt; .05). In-hospital and at 3-month and 6-month follow-ups, the MACCE
      rate and frequency of bleeding events were similar between the 2 groups (P &gt;
      .05).Intra-coronary delivery of tirofiban through aspiration catheter led to
      better myocardial perfusion in STEMI patients over 60 years of age undergoing PCI
      compared with intra-coronary injection of tirofiban through guiding catheter. The
      2 delivery routes were associated with similar rates of MACCEs and bleeding
      events.
FAU - Hu, Sigan
AU  - Hu S
AD  - Department of Cardiology, the First Affiliated Hospital of Bengbu Medical
      College, Bengbu, Anhui, People's Republic of China.
FAU - Wang, Hongju
AU  - Wang H
FAU - Zhu, Jian
AU  - Zhu J
FAU - Li, Miaonan
AU  - Li M
FAU - Li, Hui
AU  - Li H
FAU - Gao, Dasheng
AU  - Gao D
FAU - Zhang, Heng
AU  - Zhang H
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Platelet Aggregation Inhibitors)
RN  - 42HK56048U (Tyrosine)
RN  - GGX234SI5H (tirofiban)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography
MH  - Angioplasty, Balloon, Coronary/methods
MH  - Catheters/trends/utilization
MH  - Drug Administration Routes
MH  - Female
MH  - Hemorrhage/drug therapy/prevention &amp; control
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/physiopathology/*therapy
MH  - Myocardial Perfusion Imaging/instrumentation
MH  - Myocardium/metabolism
MH  - Percutaneous Coronary Intervention/*methods
MH  - Platelet Aggregation Inhibitors/therapeutic use
MH  - ST Elevation Myocardial Infarction/*drug therapy/therapy
MH  - Stroke/complications/mortality
MH  - Treatment Outcome
MH  - Tyrosine/administration &amp; dosage/*analogs &amp; derivatives/therapeutic use
EDAT- 2018/05/26 06:00
MHDA- 2018/06/05 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/05 06:00 [medline]
AID - 10.1097/MD.0000000000010850 [doi]
AID - 00005792-201805250-00058 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(21):e10850. doi: 10.1097/MD.0000000000010850.