Efficacy and safety of intracoronary injection of teneplase versus tirofiban on the treatment of acute ST-segment elevation myocardial infarction

doi:10.3969/j.issn.1004-583X.2024.07.003

Abstract

Abstract:

Objective To observe and compare the efficacy and safety of intracoronary injection of teneplase and tirofiban in the treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods A retrospective analysis was performed on 46 patients with STEMI who underwent primary percutaneous coronary intervention (PCI) in the Affiliated BenQ Hospital of Nanjing Medical University from August 2021 to August 2023. According to different treatment plans, patients were divided into observation group (n=21, intracoronary injection of teneplase) and control group (n=25, intracoronary injection of tirofiban). The number of stents, thrombolysis in myocardial infarction (TIMI) blood flow grading, TIMI thrombus grading, corrected TIMI blood flow frame count (CTFC), percentage of postoperative 2-hour ST segment regression (STR)≥50%, postoperative N-terminal pro-brain natriuretic peptide (NT-proBNP), left ventricular ejection fraction at 72 hours after PCI, bleeding events and cardiovascular adverse events during hospitalization were compared between the two groups. Results In terms of effectiveness, TIMI thrombus classification and CTFC after intracoronary administration were superior in the observation group than control group (P<0.05), and postoperative left ventricular ejection fraction (LVEF) and postoperative NT-proBNP of observation group were superior to control group (P<0.05). There were no significant differences in the number of stents, TIMI blood flow grade and percentage of postoperative 2-hour STR≥50% between the two groups (P>0.05). In terms of safety, there were no significant differences in the incidence of bleeding events and cardiovascular adverse events during hospitalization between the two groups (P>0.05). Conclusion PCI combined with intracoronary injection of teneplase and tirofiban is safe and effective on treating STEMI, and teneplase is superior to tirofiban.

Key words: ST-segment elevation myocardial infarction, percutaneous coronary intervention, intracoronary injection, teneplase, tirofiban

CLC Number:

R542.22

Zhang Lei, Li Xin, Guo Zhenfeng. Efficacy and safety of intracoronary injection of teneplase versus tirofiban on the treatment of acute ST-segment elevation myocardial infarction[J]. Clinical Focus, 2024, 39(7): 598-602.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2024.07.003

https://huicui.hebmu.edu.cn/EN/Y2024/V39/I7/598

Figures/Tables 6

Tab.1 Baseline data and intervention-related conditions between groups

项目	对照组( $n$ =25)	观察组( $n$ =21)	$t$ /χ²值	P值
男性[例(%)]	23(92.0)	17(81.0)	1.228	0.268
年龄(岁)	57.60±12.15	60.19±12.50	0.709	0.482
发病至就诊时间(h)	1.94±1.43	2.34±1.98	0.799	0.429
高血压[例(%)]	15(60.0)	15(71.4)	0.657	0.418
糖尿病[例(%)]	6(24.0)	7(33.3)	0.49	0.484
高脂血症[例(%)]	17(68.0)	12(57.1)	0.577	0.447
吸烟史[例(%)]	18(72.0)	14(66.7)	0.153	0.695
血肌酐(μmol/L)	85±20.85	82.71±22.80	0.355	0.724
血小板(×109/L)	252.88±75.88	285.95±125.48	1.101	0.277
罪犯血管[例(%)]
LAD	15(60.0)	10(47.6)
LCX	3(12.0)	4(19.0)	0.801	0.670
RCA	7(28.0)	7(33.3)
支架个数(个)	1.12±0.53	1.33±0.48	-1.422	0.162

Tab.1 Baseline data and intervention-related conditions between groups

项目	对照组( $n$ =25)	观察组( $n$ =21)	$t$ /χ²值	P值
男性[例(%)]	23(92.0)	17(81.0)	1.228	0.268
年龄(岁)	57.60±12.15	60.19±12.50	0.709	0.482
发病至就诊时间(h)	1.94±1.43	2.34±1.98	0.799	0.429
高血压[例(%)]	15(60.0)	15(71.4)	0.657	0.418
糖尿病[例(%)]	6(24.0)	7(33.3)	0.49	0.484
高脂血症[例(%)]	17(68.0)	12(57.1)	0.577	0.447
吸烟史[例(%)]	18(72.0)	14(66.7)	0.153	0.695
血肌酐(μmol/L)	85±20.85	82.71±22.80	0.355	0.724
血小板(×109/L)	252.88±75.88	285.95±125.48	1.101	0.277
罪犯血管[例(%)]
LAD	15(60.0)	10(47.6)
LCX	3(12.0)	4(19.0)	0.801	0.670
RCA	7(28.0)	7(33.3)
支架个数(个)	1.12±0.53	1.33±0.48	-1.422	0.162

Tab.2 TIMI blood flow grading after intracoronary administration in two groups

组别	例数	0~1级	2级	3级
对照组	25	0	2(8.0)	23(92.0)
观察组	21	0	1(4.8)	20(95.2)
$Z$ 值			0.196
P值			>0.05

Tab.2 TIMI blood flow grading after intracoronary administration in two groups

组别	例数	0~1级	2级	3级
对照组	25	0	2(8.0)	23(92.0)
观察组	21	0	1(4.8)	20(95.2)
$Z$ 值			0.196
P值			>0.05

Tab.3 Thrombus reduction after intracoronary administration between groups

组别	例数	无缩小(无效)	缩小(有效)
对照组	25	22(88.0)	3(22.0)
观察组	21	13(61.9)	8(38.1)
χ²值		4.271
P值		<0.05

Tab.4 CTFC between groups before and after intracoronary administration

组别	例数	给药前	给药后
对照组	25	29.92±4.57	28.57±4.66^*
观察组	21	28.41±2.96	24.18±3.09^*
$t$ 值		1.047	12.747
P值		>0.05	<0.05

Tab.4 CTFC between groups before and after intracoronary administration

组别	例数	给药前	给药后
对照组	25	29.92±4.57	28.57±4.66^*
观察组	21	28.41±2.96	24.18±3.09^*
$t$ 值		1.047	12.747
P值		>0.05	<0.05

Tab.5 Postoperative percentage of STR ≥ 50 %, NT-proBNP and LVEF between groups

组别	例数	LVEF (%)	STR≥50% [例(%)]	NT-proBNP (pg/ml)
对照组	25	54.68±9.16	18(72.0)	1 798.85±1 383.79
观察组	21	59.81±6.75	18(85.7)	1 019.98±870.38
$t$ /χ²值		-2.125	1.262	2.32
P值		0.039	0.261	0.025

Tab.5 Postoperative percentage of STR ≥ 50 %, NT-proBNP and LVEF between groups

组别	例数	LVEF (%)	STR≥50% [例(%)]	NT-proBNP (pg/ml)
对照组	25	54.68±9.16	18(72.0)	1 798.85±1 383.79
观察组	21	59.81±6.75	18(85.7)	1 019.98±870.38
$t$ /χ²值		-2.125	1.262	2.32
P值		0.039	0.261	0.025

Tab.6 The incidence of bleeding events and cardiovascular adverse events during hospitalization between groups

组别	例数	出血	心衰	室性心律失常	死亡
对照组	25	1(4.0)	2(8.0)	2(8.0)	0
观察组	21	1(4.8)	1(4.8)	1(4.8)	0
χ²值		0.016	0.196	0.196	-
P值		>0.05	>0.05	>0.05	-

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