Comparison of tirofiban combined with dalteparin or unfractionated heparin in primary percutaneous coronary intervention of acute ST-segment elevation myocardial infarction patients  

作　　者：LI Wei-ming YANG Xin-chun WANG Le-feng GE Yong-gui WANG Hong-shi XU Li NI Zhu-hua ZHANG Da-peng 

机构地区：[1]The Heart Center, Beijing Chao Yang Hospital, Capital MedicalUniversity, Beijing 100020, China

出　　处：《Chinese Medical Journal》2011年第20期3275-3280,共6页中华医学杂志（英文版）

摘　　要：Background Primary percutaneous coronary intervention （PCI） is the best treatment of choice for acute ST segment elevation myocardial infarction （STEMI）. This study aimed to determine the clinical outcomes of tirofiban combined with the low molecular weight heparin （LMWH）, dalteparin, in primary PCI patients with acute STEMI. Methods From February 2006 to July 2006, a total of 120 patients with STEMI treated with primary PCI were randomised to 2 groups： unfractionated heparin （UFH） with tirofiban （group I： 60 patients, （61.2±9.5） years）, and dalteparin with tirofiban （group il： 60 patients, （60.5±10.1） years）. Major adverse cardiac events （MACE） during hospitalization and at 4 years after PCI were examined. Bleeding complications during hospitalization were also examined. Results There were no significant differences in sex, mean age, risk factors, past history, inflammatory marker, or echocardiography between the 2 groups. In terms of the target vessel and vascular complexity, there were no significant differences between the 2 groups. During the first 7 days, emergent revascularization occurred only in 1 patient （1.7%） in group I. Acute myocardial infarction （AMI） occurred in 1 （1.7%） patient in group I and in 1 （1.7%） in group II. Three （5.0%） patients in group I and 1 （1.7%） in group II died. Total in-hospital MACE during the first 7 days was 4 （6.7%） in group I and 2 （3.3%） in group Ⅱ. Bleeding complications were observed in 10 patients （16.7%） in group I and in 4 patients （6.7%） in group II, however, the difference was not statistically significant. No significant intracranial bleeding was observed in either group. Four years after PCI, death occurred in 5 （8.3%） patients in group I and in 4 （6.7%） in group Ⅱ. MACE occurred in 12 （20.0%） patients in group I and in 10 （16,7%） patients in group Ⅱ. Conclusions Dalteparin was effective and safe in primary PCI of STEMI patients and combined dalteparin with tBackground Primary percutaneous coronary intervention （PCI） is the best treatment of choice for acute ST segment elevation myocardial infarction （STEMI）. This study aimed to determine the clinical outcomes of tirofiban combined with the low molecular weight heparin （LMWH）, dalteparin, in primary PCI patients with acute STEMI. Methods From February 2006 to July 2006, a total of 120 patients with STEMI treated with primary PCI were randomised to 2 groups： unfractionated heparin （UFH） with tirofiban （group I： 60 patients, （61.2±9.5） years）, and dalteparin with tirofiban （group il： 60 patients, （60.5±10.1） years）. Major adverse cardiac events （MACE） during hospitalization and at 4 years after PCI were examined. Bleeding complications during hospitalization were also examined. Results There were no significant differences in sex, mean age, risk factors, past history, inflammatory marker, or echocardiography between the 2 groups. In terms of the target vessel and vascular complexity, there were no significant differences between the 2 groups. During the first 7 days, emergent revascularization occurred only in 1 patient （1.7%） in group I. Acute myocardial infarction （AMI） occurred in 1 （1.7%） patient in group I and in 1 （1.7%） in group II. Three （5.0%） patients in group I and 1 （1.7%） in group II died. Total in-hospital MACE during the first 7 days was 4 （6.7%） in group I and 2 （3.3%） in group Ⅱ. Bleeding complications were observed in 10 patients （16.7%） in group I and in 4 patients （6.7%） in group II, however, the difference was not statistically significant. No significant intracranial bleeding was observed in either group. Four years after PCI, death occurred in 5 （8.3%） patients in group I and in 4 （6.7%） in group Ⅱ. MACE occurred in 12 （20.0%） patients in group I and in 10 （16,7%） patients in group Ⅱ. Conclusions Dalteparin was effective and safe in primary PCI of STEMI patients and combined dalteparin with t

关 键 词：acute myocardial infarction  heparin primary percutaneous coronary intervention 

分 类 号：S854.42[农业科学—临床兽医学] TQ464.1[农业科学—兽医学]