Effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular function in myocardial infarction: a 3D echocardiography-based evaluation

Q: What are the key findings of this study?

Adjunctive tirofiban during primary PCI was associated with a lower 90-day MACE rate (12.50% vs 35.42%; RR 0.35, 95% CI 0.15-0.82, P=0.009) and greater LVEF improvement than PCI alone.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: ST-segment elevation myocardial infarction (STEMI) with left ventricular dysfunction undergoing primary PCI (n=96). Intervention: Adjunctive tirofiban during primary PCI vs. Primary PCI alone without glycoprotein IIb/IIIa receptor inhibitor (both groups received aspirin, clopidogrel, and periprocedural unfractionated heparin). Primary outcome: Major adverse cardiac events (MACE: composite of cardiac death, recurrent myocardial infarction, hospitalization for worsening heart failure, and unplanned target-vessel revascularization) at 90 days (RR 0.35, 95% CI 0.15-0.82, p=0.009).

Q: What does this research mean for the field?

Adjunctive tirofiban during primary PCI improves myocardial perfusion, enhances left ventricular ejection fraction recovery, and reduces 90-day major adverse cardiac events in STEMI patients. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Xili Wang; Yingjuan Han; Chenxue Zhang

doi:10.3389/fcvm.2026.1857341

October 30, 2026Frontiers in Cardiovascular MedicineOpen Access

Effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular function in myocardial infarction: a 3D echocardiography-based evaluation

View Full Paper

Ask AI

Bookmark

Share

Key result

Adjunctive tirofiban during primary PCI is linked to ~65% lower 90-day MACE versus PCI alone.

RR 0.35
95% CI 0.15-0.82
P=0.009
n=96

Why the study?

The effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular functional recovery in myocardial infarction patients, assessed by angiographic myocardial blush grade and 3D echocardiography, needed evaluation.

Does planned adjunctive intracoronary and intravenous tirofiban during primary PCI improve myocardial perfusion, left ventricular functional recovery, and 90-day MACE compared with primary PCI alone in patients with STEMI and left ventricular dysfunction?

Key Points

To evaluate the effects of adjunctive tirofiban during primary percutaneous coronary intervention on myocardial perfusion and ventricular functional recovery in patients with myocardial infarction.
Retrospective review of 114 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI between March 2024 and May 2025, categorized into PCI alone (n=61) or PCI with adjunctive tirofiban (n=53).
Applied 1:1 propensity score matching based on age, sex, and baseline left ventricular ejection fraction (LVEF), yielding 48 matched pairs (96 patients) for final analysis.
Assessed myocardial perfusion via angiographic myocardial blush grade (MBG) and quantified LVEF using three-dimensional echocardiography offline TomTec analysis, with 90-day follow-up for major adverse cardiac events (MACE).
The tirofiban group achieved significantly higher post-treatment MBG (2.42 ± 1.02 vs. 1.58 ± 0.88, P < 0.001) and LVEF (55.74 ± 3.12 vs. 48.89 ± 5.17, P < 0.001) compared to the control group.
Patients receiving tirofiban demonstrated significantly lower cTnI (12.34 ± 1.76 vs. 16.73 ± 1.98, P < 0.001), higher SOD (100.89 ± 3.21 vs. 90.11 ± 2.86, P < 0.001), and lower ET (58.42 ± 1.65 vs. 77.24 ± 1.83, P < 0.001).
During 90-day follow-up, the incidence of MACE was significantly lower in the tirofiban group than in the control group (6/48, 12.50% vs. 17/48, 35.42%; P = 0.009).

Study Design

Type

Cohort (n=96)

Blinding

Blinded outcome assessment (echocardiography and angiography readers blinded to treatment allocation)

Multicenter

No

Structured PICO

Does planned adjunctive intracoronary and intravenous tirofiban during primary PCI improve myocardial perfusion, left ventricular functional recovery, and 90-day MACE compared with primary PCI alone in patients with STEMI and left ventricular dysfunction?

P

Population

96 propensity score-matched patients with first-time STEMI and baseline left ventricular dysfunction undergoing primary PCI in China, followed for 90 days.

E

Exposure

Planned adjunctive tirofiban administered intracoronarily at a bolus dose of 10 μg/kg through the guiding catheter during primary PCI, followed immediately by a continuous intravenous infusion at 0.15 μg/kg/min for 18 hours, added to standard therapy (pre-PCI aspirin and clopidogrel, periprocedural unfractionated heparin, and post-PCI aspirin 100 mg once daily plus clopidogrel 75 mg once daily).

C

Comparator

Primary PCI without a glycoprotein IIb/IIIa receptor inhibitor, with both groups receiving standard antiplatelet therapy (aspirin and clopidogrel before PCI, periprocedural unfractionated heparin, and post-PCI dual antiplatelet therapy with aspirin 100 mg once daily and clopidogrel 75 mg once daily).

O

Outcome

Six principal outcome domains assessed with Holm-Bonferroni multiplicity adjustment: 90-day Major Adverse Cardiac Events (MACE: composite of cardiac death, recurrent myocardial infarction, hospitalization for worsening heart failure, and unplanned target-vessel revascularization), change in angiographic myocardial blush grade (MBG), change in 3D echocardiographic left ventricular ejection fraction (LVEF) at day 7, and changes in serum cardiac troponin I (cTnI), superoxide dismutase (SOD), and endothelin (ET) at day 7.composite

Main Result

Relative Risk: 0.35 (95% CI 0.15–0.82)

Absolute Event Rate: 12.5% vs 35.42%

p-value: p=0.009

In a propensity-matched cohort of STEMI patients with left ventricular dysfunction, planned adjunctive tirofiban during primary PCI was associated with improved microvascular perfusion (MBG), better 7-day 3D echocardiographic LVEF recovery, and lower 90-day MACE without a statistically significant excess in bleeding.

Limitations

Single-center retrospective study design
Residual confounding from unmeasured or incompletely measured factors cannot be excluded despite propensity score matching
Relatively limited sample size (96 matched patients), which may be underpowered to detect uncommon bleeding complications
Single-center retrospective design
Residual confounding from unmeasured or incompletely measured factors cannot be excluded despite 1:1 propensity score matching
Relatively limited sample size (48 matched pairs), underpowered to detect uncommon but clinically important bleeding complications

Implication

Adjunctive tirofiban was associated with lower 90-day MACE and greater LVEF recovery; hypothesis-generating in observational data and requires randomized confirmation.

Abstract

Objective This study aimed to evaluate the effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular functional recovery in patients with myocardial infarction using angiographic myocardial blush grade (MBG) and three-dimensional echocardiography (3DE). Methods A retrospective review identified 114 eligible patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI at our hospital from March 2024 to May 2025, including 61 patients who received PCI alone and 53 who received PCI with adjunctive tirofiban. After 1:1 propensity score matching (PSM), 48 matched pairs (96 patients) were included in the final analysis. Myocardial perfusion was assessed using angiographic myocardial blush grade (MBG), whereas left ventricular ejection fraction (LVEF) was quantified from three-dimensional echocardiographic full-volume datasets using offline TomTec analysis. Major adverse cardiac events (MACE) were recorded during a 90-day follow-up after PCI and included cardiac death, recurrent myocardial infarction, hospitalization for worsening heart failure, and unplanned target-vessel revascularization. Results The general baseline data of the two groups showed no statistically significant difference, indicating comparability ( P > 0.05). Baseline MBG, LVEF, cTnI, SOD, and ET levels were also comparable between the two groups (all P > 0.05). Both groups showed significant changes from baseline after treatment, with greater improvements in these indicators observed in the treatment group (all P < 0.001 for between-group comparisons of changes). The myocardial blush grade (MBG) and left ventricular ejection fraction (LVEF) were significantly higher in the treatment group than in the control group (2.42 ± 1.02 vs. 1.58 ± 0.88 and 55.74 ± 3.12 vs. 48.89 ± 5.17, respectively; both P < 0.001). The cardiac troponin I (cTnI) level was significantly lower in the treatment group than in the control group (12.34 ± 1.76 vs. 16.73 ± 1.98, P < 0.001). The treatment group also showed a significantly higher superoxide dismutase (SOD) level (100.89 ± 3.21 vs. 90.11 ± 2.86, P < 0.001) and a significantly lower endothelin (ET) level (58.42 ± 1.65 vs. 77.24 ± 1.83, P < 0.001). During the 90-day follow-up, the incidence of MACE was significantly lower in the treatment group than in the control group (6/48, 12.50% vs. 17/48, 35.42%; P = 0.009). Conclusion Adjunctive tirofiban during PCI was associated with greater improvements in myocardial perfusion and ventricular functional recovery than PCI alone. Three-dimensional echocardiography provided quantitative assessment of ventricular functional changes, while angiographic MBG provided complementary information on myocardial tissue perfusion. Given the single-center retrospective design, these findings should be interpreted cautiously and require confirmation in larger prospective studies.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Wang et al. (2026) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) with left ventricular dysfunction undergoing primary PCI (n=96). Adjunctive tirofiban during primary PCI vs. Primary PCI alone without glycoprotein IIb/IIIa receptor inhibitor (both groups received aspirin, clopidogrel, and periprocedural unfractionated heparin) was evaluated on Major adverse cardiac events (MACE: composite of cardiac death, recurrent myocardial infarction, hospitalization for worsening heart failure, and unplanned target-vessel revascularization) at 90 days (RR 0.35, 95% CI 0.15-0.82, p=0.009). Adjunctive tirofiban during primary PCI was associated with a lower 90-day MACE rate (12.50% vs 35.42%; RR 0.35, 95% CI 0.15-0.82, P=0.009) and greater LVEF improvement than PCI alone.

synapsesocial.com/papers/6ae682cae432e7a5c4ef376d https://doi.org/10.3389/fcvm.2026.1857341

View Full Paper

Ask AI

Bookmark

Share

Effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular function in myocardial infarction: a 3D echocardiography-based evaluation

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Effects of adjunctive tirofiban during PCI on myocardial perfusion and ventricular function in myocardial infarction: a 3D echocardiography-based evaluation

Key Points

Study Design

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading