Intracoronary injection of eptifibatide in patients with acute STEMI with primary angioplasty and its outcome

Abstract

Full and early restoration of blood flow to coronary arteries is the main purpose of treatment in the patients with myocardial infarction. Primary angioplasty is not always successful in restoring myocardial blood flow. Although the strategy of adding integrilin leads to better blood circulation, its value as a conventional strategy is questionable. Therefore, the present study was conducted to investigate the effectiveness of intracoronary administration of integrilin in the patients under treatment with primary coronary intervention. Materials methods and: In this retrospective study, the subjects included in the study were 302 patients suffering from STEMI who had referred to Shahid Madani Hospital of Tabriz within time interval less than 12 hours from the onset of symptoms, and underwent successful primary angioplasty. After applying inclusion and exclusion criteria, the patients were divided into two equal groups. The first group underwent intracoronary integrilin treatment immediately before angioplasty. The second group underwent coronary angioplasty along with standard treatment. Then the two groups were investigated in terms of clinical outcomes such as mortality, bleeding, and heart failure. Results: A total of 302 patients were included in the study, and the mean age of the group receiving integrilin and the standard treatment were 57.07 ±10.81 and 58.90±12.58 , respectively; no significant difference was observed between the two groups (P value=0/066). The mean ejection fraction during hospitalization was 38.147±9.17 percent and 38.82 ± 6.64 percent in the group receiving integrilin and standard treatment group. There was no significant difference between the two groups (P value=0/220). The amount of ST resolution more than 50% was 88% and 73.53% in the group receiving integrilin and standard treatment group, respectively. There was a significant difference between the two groups (P value<0.001). The mean Peak CTNI (Peak cardiac troponin I) was 13.65 ± 9.32 ng / dl and 13.62± 8.05 ng / dl in the integrilin group and the standard treatment group, respectively, and there was no significant difference between the two groups (P value= 0.787). 2 (1.0%) people from the group receiving integrilin died due to cardiovascular causes during hospitalization, and nobody died from the standard treatment group. There was no significant difference between the two groups (P value = 0.712). Of the patients receiving integrilin, 5 patients (2.5%) had major bleeding and 8 patients (4%) had minor bleeding. Of the patients with standard treatment, 1 (1%) had major bleeding and 5 (5%) had minor bleeding. Although bleeding was more common in the group receiving integrilin than the standard treatment group, there was no significant difference between the two groups (P value= 0.711). The incidence of heart failure was significant between the two groups. In other words, heart failure was more common in the standard treatment group (P value= 0.001).