Key result
Thrombectomy plus intracoronary tirofiban reduces 6-month MACE vs. standard PPCI or thrombectomy alone in STEMI.
Why the study?
Does thrombectomy combined with intracoronary tirofiban improve coronary flow and reduce MACE in STEMI patients undergoing PPCI?
RCT (n=240)
Open-label
Randomly assigned to 1 of 3 groups
No
Does thrombectomy combined with intracoronary tirofiban improve coronary flow and reduce MACE in STEMI patients undergoing PPCI?
p-value: p=0.038
In STEMI patients undergoing primary PCI, the combination of aspiration thrombectomy and intracoronary tirofiban improves coronary flow and reduces 6-month major adverse cardiac events compared to thrombectomy alone or standard PCI.
Supports combined thrombectomy plus intracoronary tirofiban in STEMI PPCI; extends evidence for adjunctive no-reflow strategies beyond thrombectomy alone.
BACKGROUND No/slow reflow gives rise to serious complications in STEMI patients undergoing PCI, and can lead to worse outcomes. Several measures are used to prevent no/slow reflow, including thrombus removal processes and intensive use of anticoagulant agents. Our study was designed to evaluate the efficacy and safety of thrombectomy and intracoronary administration of GPIIb/IIIa inhibitors in STEMI patients undergoing PPCI. MATERIAL AND METHODS We randomly assigned 240 STEMI patients into 3 groups. Before PPCI, patients in group A received thrombectomy and intracoronary administration of tirofiban. Patients in group B received thrombectomy, and patients in group C neither of these 2 treatments. Their demographic data and coronary angiography results were recorded. TIMI grade flow was used to evaluate the effect. After the follow-up, major adverse cardiac events were regarded as study endpoints in evaluating the safety of the combined therapy. RESULTS We found no significant differences among the 3 groups in demographic and clinical characteristics (p>0.05). Patients in group A had better TIMI grade classifications and ST-segment elevation (p=0.005), and lower incidence of no/slow reflow (p=0.031) and MACE. During 6-month follow-up, the MACE rate was lower in group A than in groups B and C (p=0.038). CONCLUSIONS The use of thrombectomy combined with intracoronary administration of tirofiban is relatively effective and safe in STEMI patients undergoing PPCI.
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Gao et al. (2016) conducted an RCT in ST-segment elevation myocardial infarction (STEMI) (n=240). Thrombectomy and intracoronary tirofiban vs. Thrombectomy alone or PPCI alone was evaluated on Major Adverse Cardiovascular Events (MACE) at 6-month follow-up (p=0.038). Thrombectomy combined with intracoronary administration of tirofiban significantly reduced the 6-month rate of major adverse cardiovascular events compared to standard PPCI or thrombectomy alone in patients with STEMI (p=0.038).
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