Effect of GP IIb/IIIa inhibitor duration on the clinical prognosis of primary percutaneous coronary intervention in ST-segment elevation myocardial infarction with no-/slow-reflow phenomenon - 09/10/21
, Weimian Wang a, b, 1 , Jingguang Ye c , Yan Lin b, d , Bingyan Yu b, e , Langping Zhou b , Yingling Zhou b, ⁎ , Haojian Dong b, ⁎, 2 Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Background |
In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) accompanied by the no-/slow-reflow phenomenon, the maintenance duration of GP IIb/IIIa inhibitor (GPI) is controversial. We compare the efficacy and safety of short- and long-term GPI infusion in STEMI patients with the no-/slow-reflow phenomenon.
Methods |
From June 2016 to December 2019, we continuously included patients with on-set STEMI who underwent pPCI, accompanied by the no-/slow-reflow, during interventional procedures at Guangdong Provincial People’s Hospital and Zhuhai Golden Bay Hospital. The hemorrhage events, heart function, and major adverse cardiovascular events (MACE) were compared between < 24 h and ≥ 24 h GPI duration groups. The Kaplan–Meier curve was used to estimate the 1-year MACE-free survival at different GPI utility times.
Results |
In total, 127 patients were divided into two groups based on the duration of tirofiban use (less and more than 24 h). There was no significant difference between two groups in terms of baseline characteristics, plaque condition, and coronary physiological function. The two groups showed similar in-hospital MACE (1 [1.85%] vs. 4 [5.48%], p = 0.394) and 1-year MACE-free survival (log-rank test p = 0.9085). The 1-year MACE remained consistent between the two groups in all subgroups of different risk factors of no-/slow-reflow. There was no significant difference in heart function and in-hospital hemorrhage events (3.7% vs. 1.37%, p = 0.179).
Conclusion |
In the real world, prolonging the duration of GPI may not significantly improve the clinical outcome in patients with STEMI with no-/slow-reflow.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | A real-world study on different duration of intravenous GPIIb/IIIa inhibitor in STEMI with no-/slow-reflow phenomenon. |
• | No significant difference between < 24 h and ≥ 24 h of tirofiban infusion regarding cardiac function and clinical outcome. |
• | In the current updated dual antiplatelet therapy, short-term tirofiban infusion may not be inferior to long-term tirofiban. |
Abbreviations : μQFR, BMS, BNP, CAG, CD, CK, CKD, CK-MB, COPD, cTNI, cTNT, DAPT, DBP, DES, SC, ECG, eGFR, GPI, HDL-c, HR, HTB, IABP, LAD, LCX, LDL-c, LM, LVEF, LVFS, LVIDd, LVIDs, LVMI, MACE, MI, MR, NT-proBNP, pPCI, PTCA, QCA, RCA, SBP, STEMI, TC, TG, TIMI, TS, TVR
Keywords : ST-Segment Elevation Myocardial Infarction, GP IIb/IIIa inhibitor, No-/slow-reflow
Plan
Vol 143
Article 112196- novembre 2021 Retour au numéro
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