Effect of varied times of tirofiban administration on post-emergency percutaneous coronary intervention in patients with acute myocardial infarction

Purpose: To determine the impact of time profile of tirofiban hydrochloride administration on short-term outcomes in patients with acute myocardial infarction (AMI) undergoing emergency percutaneous coronary intervention (PCI). Methods: A total of 112 patients with AMI who received PCI treatment in The First People's Hospital of Tianshui, Tianshui, China were randomly and equally assigned to study and control groups. The study group received intravenous tirofiban hydrochloride bolus (10 μg/kg) 1 - 2 h before PCI, followed by sustained infusion at 0.15 μg/kg/min for 36 h after the procedure. Control group received the same regimen immediately after PCI. Myocardial injury markers, cardiac functional parameters, ST-segment resolution, myocardial perfusion changes, bleeding complications, and adverse cardiovascular events over 6 months were evaluated. Results: When compared with control group, the study group exhibited significantly lower cardiac troponin T (cTnT) levels and lower serum creatine kinase-MB (CK-MB) levels at 7 days post-PCI (p < 0.05). Furthermore, the study group showed significantly reduced left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD), along with higher left ventricular ejection fraction (LVEF) after 7 days (p < 0.05). The study group also exhibited superior ST-segment resolution and significant improvement in myocardial perfusion 90 min post-treatment and significantly lower incidence of reperfusion arrhythmias (p < 0.05). Both groups had similar rates of minor bleeding events and no incidence of severe complications or fatalities. Conclusions: Administering tirofiban preoperatively enhances coronary blood flow, improves myocardial perfusion, and reduces the risk of distal embolic events without increasing severe bleeding complications. Larger-scale, multicenter studies with longer follow-up periods are required to confirm these findings and evaluate the safety and efficacy of different administration time for tirofiban infusion in patients with AMI undergoing PCI.