Efficacy and Safety of Intracoronary Administration of Tirofiban through Perforated Balloon Technique in Patients with St-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Objective: To assess the safety and efficacy of intracoronary (IC) versus Intralesional (IL) administration of   tirofiban during primary (PCI) in patients with acute ST segment elevation myocardial infarction. Patients and Methods: This research involved 95 patients who were randomly assigned to recieve either IC bolus plus maintenance or IL bolus plus maintenance of tirofiban. Both groups were compared for pre and post intervention for cardiac marker, myocardial perfusion, and Major composite adverse cardiac event incidence at 3 months were recorded.  Results: Incidence of major adverse cardiac events was not different between groups, but Post procedure TIMI flow III and MBG III were significant in IL group with p = 0.03*, and 0.022* respectively favoring distal intracoronary strategy. Peak CK-MB values were lower in IL tirofiban group than IC group, 172.79±18.37, 184.58 ± 19.93 respectively with significant (p=0.021). ST segment resolution and 3 months LVEF in IL group were significantly higher in IL group than in IC group (p= 0.016*) respectively. Conclusion: local intracoronary tirofiban infusion via perforated balloon technique at the time of PPCI was associated with reduced thrombus burden, improved immediate angiographic outcome, and 3-month EF, compared with intracoronary GPI bolus injection via the guiding catheter.