Clinical evaluation of thrombus aspiration combined with tirofiban in patients with acute myocardial infarction with elective percutaneous coronary intervention.

OBJECTIVE: To compare the efficacy and safety of combined treatment with thrombus aspiration and intracoronary tirofiban in patients with acute myocardial infarction (MI), with elective percutaneous coronary intervention (PCI). METHODS: Patients undergoing elective PCI during recovery from acute MI were randomized into two groups; the intervention group received thrombus aspiration and intracoronary tirofiban; the control group received conventional PCI. Baseline clinical characteristics, postoperative coronary blood flow (thrombolysis in myocardial infarction [TIMI] grade), TIMI myocardial perfusion (TMP) grade, no/slow reflow rate and cardiac function (measured by echocardiography 1 month postoperatively) were evaluated. Major adverse cardiac event rate and bleeding complications during surgery (and at 1 month and 1 year postoperatively) were also evaluated. RESULTS: A total of 80 patients were included. Postoperatively, the number of patients with TIMI flow grade 3 and the mean TMP grade were both significantly higher, and the no/slow reflow rate was significantly lower, in the intervention group versus the control group. Echocardiography indicated that cardiac function was significantly improved in the intervention group compared with the control group. There were no major complications in either study group. CONCLUSION: Thrombus aspiration combined with intracoronary tirofiban during recovery from acute MI was effective and relatively well tolerated.