RESUMEN
OBJECTIVE: This study aimed to explore the short-term efficacy and safety of primary percutaneous coronary intervention (PCI) in female diabetic patients complicated with acute myocardial infarction (AMI). METHODS: A total of 169 diabetic patients with AMI who underwent primary PCI were selected and divided into group A (52 females) and group B (117 males). The clinical data, characteristics of coronary artery lesions, lengths of hospital stay, and incidences of complications were then compared between two groups. RESULTS: The average age, history of hyperlipidemia, double branch lesions, triple branch lesions, and left main lesions were significantly higher in group A than in group B (P < 0.05). Smoking history, PCI history, and pre-infarction angina were distinctly lower in group A than in group B (P < 0.05). Thrombolysis in myocardial infarction 3 (TIMI3) flow and TIMI myocardial perfusion grade 3 (TMPG3) after PCI were markedly lower in group A than in group B (P < 0.001). Group A had a higher incidence of complications, such as severe arrhythmia, cardiac function Killip III/IV, cardiogenic shock, major, moderate and mild bleed event, as well as a 30-day mortality rate, compared with group B (P < 0.05). CONCLUSION: In summary, our study demonstrated that female diabetic patients with AMI had lower TIMI3 flow and TMPG3 following PCI than male patients, while there was higher incidence of complications and 30-day mortality rate. Therefore, more attention should be paid to the therapy of diabetic women with acute myocardial infarction as well as the control of risk factors.
RESUMEN
OBJECTIVE: This work aims to explore the short-term efficacy and safety of coronary arterial injection of tirofiban in elderly diabetic patients complicated with acute myocardial infarction (AMI) who underwent emergency percutaneous coronary intervention (PCI). METHODS: Ninety-seven elderly diabetic patients complicated with ST-elevation myocardial infarction (STEMI) who underwent emergency PCI were selected and randomized into control (group A, 49 cases) and tirofiban (group B, 48 cases) groups. Another 129 nonelderly diabetic patients (group C) complicated with STEMI who underwent emergency PCI and tirofiban treatment in the corresponding period were also involved for comparison. RESULTS: Thrombolysis in myocardial infarction 3 (TIMI3) flow was significantly higher in groups B and C than in group A after PCI (p < 0.01). TIMI myocardial perfusion grades (TMPG) 0 to 1 and 2 were distinctly lower (p < 0.01, p < 0.05) and TMPG3 was obviously higher (p < 0.01) in groups B and C than in group A. The average length of hospital stay, post-infarction angina pectoris, severe arrhythmia, and cardiac function Killip III to IV were markedly lower in groups B and C than in group A (p < 0.01, p < 0.05). Meanwhile, mucocutaneous hemorrhage was significantly higher in groups B and C than in group A (p < 0.01). CONCLUSIONS: Tirofiban effectively improved TIMI flow and TMPG perfusion in elderly diabetic patients complicated with AMI and reduced the incidence of serious complications without increasing the occurrence of severe hemorrhage. KEY WORDS: Acute myocardial infarction; Diabetes mellitus; Emergency percutaneous coronary intervention; Tirofiban.