Effect of Intracoronary Vs. Intravenous Tirofiban Bolus on Myocardial Flow Grades in Acute STEMI

Authors

  • Syed Husnain Raza Bukhari DHQ Hospital, Sheikhupura-Pakistan.
  • Muhammad Anjum Punjab Institute of Cardiology, Lahore-Pakistan.
  • Abdul Basit DHQ Hospital, Sheikhupura-Pakistan.
  • Javid Iqbal Multan Institute of Cardiology, Multan-Pakistan.
  • Husnain Shoukat THQ Hospital Mailsi District, Vehari-Pakistan.
  • Junaid Salah Ud din Punjab Institute of Cardiology, Lahore-Pakistan.

Abstract

Background: There are a few studies about the advantages and risks of using tirofiban via the intracoronary vs intravenous route in patients with ST-segment elevation myocardial infarction. In this study, the comparison of the efficacy of intracoronary vs intravenous tirofiban is assessed.

Methodology: This comparative study was conducted at the Punjab Institute of Cardiology, Lahore, from March 2019 to March 2020. A total of 250 patients of both genders, aged between 20 to 65 years, were enrolled in this study (March 2019 to March 2020) who had STEMI and had high thrombus burden or TIMI flow grade <3 During Primary PCI. The patients were divided into two groups, namely the intracoronary tirofiban group and the intravenous tirofiban group. Both groups were compared for final TIMI flow and Myocardial blush grade. Moreover, major and minor bleeding, hematoma and mortality was compare among both groups. The data was analyzed using SPSS v23.0. The chi-square test was applied to obtain the comparative analysis. A p-value ≤0.05 was considered statistically significant.

Results: TIMI flow grades in both groups were not similar and showed significant differences, which indicated that both groups were independent as p-value <0.05. TIMI flow grade III was achieved in 83.2% in group A, whereas in group B, it was only 28.8%. The myocardial blush grade was compared in both groups, and the result showed that scores in both the groups were not similar, having significant differences as the p-value was 0.00 (84.8% vs. 46.4%), major and minor bleeding results were compared among both groups and showed statistical insignificance results as p-value = 0.625 (6.4% vs. 8.0%) and 0.705 (12% vs. 13.6%) respectively. The Chi-square results regarding hematoma, Major Adverse Cardiovascular Events (MACE), and mortality in intracoronary and intravenous tirofiban groups were not statistically significant as the p-values were 0.338 (30.4% vs. 27.2%), 0.447 (34.4% vs. 32.8%) and 0.591(2.4% vs. 3.2%) respectively.

Conclusion: In contrast to intravenous administration, the intracoronary administration of tirofiban has shown a superior improvement in myocardial flow grades, including TIMI-flow grade and Myocardial blush grade

Downloads

Published

01.12.2023

How to Cite

Syed Husnain Raza Bukhari, Anjum, M., Basit, A., Iqbal, J., Shoukat, H., & Salah Ud din, J. (2023). Effect of Intracoronary Vs. Intravenous Tirofiban Bolus on Myocardial Flow Grades in Acute STEMI. Pakistan Journal of Cardiovascular Intervention, 3(2), 20–25. Retrieved from https://pjcvi.com/index.php/ojs/article/view/50