Effect of Antiplatelet Therapy Combining Aspirin with Tirofiban After Percutaneous Coronary Intervention on the Incidence of Re-occlusion of Blood Vessels and Platelet Aggregation Rate in Patients with Acute Myocardial Infarction

2021 ◽  
Vol 7 (5) ◽  
pp. 4049-4056
Author(s):  
Tongtong Wu ◽  
Fang Cheng
Keyword(s):  
Platelet Aggregation ◽  
Blood Vessels ◽  
Antiplatelet Therapy ◽  
Peak Velocity ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Control Group ◽  
Aggregation Rate ◽  
Percutaneous Coronary ◽  
Experimental Group

Objective. To explore the effect of antiplatelet therapy combining aspirin with tirofiban after percutaneous coronary intervention (PCI) on the incidence of re-occlusion of blood vessels and platelet aggregation rate in patients with acute myocardial infarction (AMI). Methods. A total of 104 AMI patients treated in the Department of Cardiovascular Medicine of our hospital from March 2017 to March 2018 were selected for retrospective analysis, and those who met the inclusion criteria were divided into the experimental group (n=52) and the control group (n=52) by sealed envelope randomization. After admission, all patients received the PCI, then the combined therapy of aspirin and tirofiban was given to the patients in the experimental group, and the patients in the control group orally took the clopidogrel. By detecting the values of n-terminal pro-brain natriuretic peptide (NT-proBNP) level, platelet active function indicators, etc. of patients in both groups after treatment, the treatment effect of antiplatelet in AMI patients after PCI with different drugs was analyzed. Results. After treatment, the levels of the maximum platelet aggregation rate (MPAR), CD63, CD62P, MA, NT-proBNP and left ventricular end-diastolic volume (LVEDV) were significantly lower in the experimental group than in the control group (P<0.001), and the R time, K time, CI values, left ventricular ejection fraction (LVEF), the peak velocity of early diastolic wave (peak E)/peak velocity of late diastolic wave (peak A) under mitral valve (E/A) were significantly higher in the experimental group than in the control group (P<0.001), and during follow-up, the incidence rate of re-occlusion of blood vessels was significantly lower in the experimental group than in the control group (P<0.05). Conclusion. The above results indicated that combining aspirin with tirofiban has a better effect than clopidogrel in the antiplatelet therapy for AMI patients after PCI, and therefore it is recommended.

scholarly journals Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Ying Hu ◽  
Fan-xing Qi ◽  
Li-na Yu ◽  
Wei Geng
Keyword(s):  
Myocardial Infarction ◽  
Platelet Aggregation ◽  
Cardiac Function ◽  
Blood Perfusion ◽  
Coronary Intervention ◽  
Control Group ◽  
Aggregation Rate ◽  
Percutaneous Coronary ◽  
Emergency Percutaneous Coronary Intervention ◽  
Experimental Group

Objectives: To investigate the effects of etibatide combined with emergency percutaneous coronary intervention (PCI) on blood perfusion and cardiac function in acute myocardial infarction (AMI) patients. Methods: This was a prospective, randomized, controlled study. From November 2015 to June 2019, 196 patients with ST-segment elevation myocardial infarction (STEMI) undergoing emergency PCI admitted to Baoding First Central Hospital were enrolled. The 196 STEMI patients were randomly divided into experimental group and control group. In the experimental group, STEMI patients were treated with emergency PCI + etibatide; while in the control group, only PCI was performed. Observation indexes included: general data, myocardial perfusion and cardiac function indexes and major adverse cardiac events (MACE). Results: There was no significant difference in general data between the two groups (P > 0.05). The rate of ST-segment resolution (STR) in the experimental group was better than that in the control group (P < 0.05). In myocardial contrast echocardiography (MCE), higher peak intensity (PI) and shorter time-to-peak (TP) were observed in the experimental group compared with the control group (P < 0.05). The platelet aggregation rate was compared between the two group at the time points of before PCI, after PCI and two hour after drug withdrawal, and there was no significant change in the platelet aggregation rate of the control group between different time points (before PCI, after PCI and two hour after drug withdrawal); while the platelet aggregation rate of the experimental group was significantly lower after PCI and two hour after drug withdrawal than that before PCI (P < 0.05), and an obviously decreased platelet aggregation rate was found in the experimental group(P < 0.05). After three months of follow-up, there was one case of MACE in the experimental group and 1 case of MACE in the control group, without any difference in the incidence of MACE between the two groups (P > 0.05). Conclusion: Etibatide combined with emergency PCI could improve myocardial reperfusion and cardiac function in patients with acute STEMI without increasing the incidence of MACE. doi: https://doi.org/10.12669/pjms.37.1.2950 How to cite this:Hu Y, Qi F, Yu L, Geng W. Effects of etibatide combined with emergency percutaneous coronary intervention on blood perfusion and cardiac function in patients with acute myocardial infarction. Pak J Med Sci. 2021;37(1):185-190.  doi: https://doi.org/10.12669/pjms.37.1.2950 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Urgent percutaneous coronary intervention leads to a decrease in serum concentrations of soluble CD40 ligand

2010 ◽  
Vol 67 (9) ◽  
pp. 732-740
Author(s):  
Nenad Ratkovic ◽  
Radoslav Romanovic ◽  
Aleksandra Jovelic ◽  
Branko Gligic ◽  
Saso Rafajlovski ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Angina Pectoris ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Cd40 Ligand ◽  
Control Group ◽  
Soluble Cd40 Ligand ◽  
Percutaneous Coronary ◽  
Experimental Group

Background/Aim. Inflammation as a consequence of vascular injury after percutaneous coronary intervention (PCI) is a pathological substrate of restenosis and of its complications. The aim of the study was to examine perprocedural inflammatory response expressed by soluble CD40 ligand (sCD40L) and C-reactive protein (CRP) in patients treated with PCI and dual antiplatelet therapy. Methods. The experimental group included 52 patients (80.8% men, age 60 ? 9 years) with angina pectoris treated by PCI (22 urgent PCI) with stent implantation, and dual antiplatelet therapy (tienopiridins and aspirin), according to the current recommendations for the execution of the intervention. The control group consisted of 8 patients (70.5% men, age 59 ? 7 years) with angina pectoris, who had undergone coronarography taking aspirin 3 days prior to it. In all the patients 24 hours before and after the PCI concentrations of CRP and sCD40L in the blood were determined. Results. In the experimental group, the concentration of sCD40L was lower as compared to the control (p < 0.02). In 34 (65%) patients postprocedural decrease in sCD40L was recorded, in 18 (34.6%) of them increase, while in 50 (96%) patients there was a rise in CRP. The patients with postprocedural fall in sCD40L hod greater preprocedural concentration of sCD40L (p < 0.001), and less postprocedural concentration of sCD40L (p < 0.001), compared to the group with an increase in sCD40L after the PCI, while CRP levels tients treated with emergency PCI compared to elective patietns had a postprocedural decrease in sCD40L (p = 0.02). Increase in the level of CRP was higher in the group with emergency PCI in relation to elective PCI (p < 0.01). Conclusion. Emergency PCI procedures in the treatment of patients with unstable angina pectoris lead to a postprocedural fall in the serum concentration of sCD40L. Dual antiplate therapy with tienopiridins and aspirin inhibits the release of sCD40L. Regardless a clinical presentation of coronary disease PCI leads to an postprocedural increase in concentrations of CRP in the serum.

scholarly journals Left Ventricular End-Diastolic Pressure and B-Type Natriuretic Peptide Levels Guidance of Low-Dose Furosemide Treatment to Prevent Contrast-Induced Nephropathy in Patients with Percutaneous Coronary Intervention: A Randomized Controlled Trial

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Guoqiang Gu ◽  
Demin Liu ◽  
Rui Lu ◽  
Wei Cui
Keyword(s):  
Low Dose ◽  
Diastolic Pressure ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Control Group ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Adequate Hydration ◽  
Furosemide Administration ◽  
Experimental Group

Objective. We aimed to explore the preventive effect of low-dose furosemide administration guided by left ventricular end-diastolic pressure (LVEDP) and B-type natriuretic peptide (BNP) based on adequate hydration on contrast-induced nephropathy (CIN) in patients with percutaneous coronary intervention (PCI). Methods. This parallel randomized clinical trial was conducted at a tertiary hospital in China. A total of 1053 consecutive patients (71.98% men) who underwent PCI at our hospital were enrolled. Pre-PCI plasma BNP levels were recorded. Patients enrolled received a continuous intravenous infusion of normal saline starting 4 h before PCI until 24 h after surgery. LVEDP was measured immediately after surgery. Patients in the control group received intravenous furosemide injection (20 mg). Patients in the experimental group received furosemide if they showed LVEDP ≥15 mmHg, a post-PCI BNP level ≥100 pg/mL, and/or a post-PCI BNP value > 150% of the pre-PCI value. The primary and secondary outcome measures were serum creatinine levels, glomerular filtration rate, and creatinine clearance rate measured before and after PCI. CIN incidence was compared between the two groups. Logistic regression analysis was used to study the risk factors for CIN. Results. CIN incidence was significantly higher in the control group than in the experimental group ( P < 0.05 ). Logistic regression analysis showed that elevated LVEDP and BNP levels were risk factors. As LVEDP increased, the CIN incidence also increased (odds ratio (OR) 1.038, 95% confidence interval (CI) 1.006–1.070). The OR of BNP was 1.001 (95% CI 1.000–1.002). Conclusions. Low-dose furosemide administration guided by LVEDP or BNP is superior to direct low-dose administration on the basis of adequate hydration during PCI. This trial is registered with ChiCTR-IOR-14005250

scholarly journals Clinical Characteristics and Outcomes From Percutaneous Coronary Intervention of Last Remaining Coronary Artery

2020 ◽  
Vol 13 (9) ◽  
Author(s):  
Ahmad Shoaib ◽  
Muhammad Rashid ◽  
Evangelos Kontopantelis ◽  
Andrew Sharp ◽  
Eoin F. Fahy ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
High Risk ◽  
Clinical Outcomes ◽  
Odds Ratio ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Sensitivity Analyses ◽  
Control Group ◽  
Percutaneous Coronary

Background: Patients with complex high-risk coronary anatomy, such as those with a last remaining patent vessel (LRPV), are increasingly revascularized with percutaneous coronary intervention (PCI) in contemporary practice. There are limited data on the outcomes of these high-risk procedures. Methods: We analyzed a large longitudinal PCI cohort (2007–2014, n=501 841) from the British Cardiovascular Intervention Society database. Clinical, demographic, procedural, and outcome data were analyzed by dividing patients into 2 groups; LRPV group (n=2432) and all other PCI groups (n=506 691). Results: Patients in the LRPV PCI group were older, had more comorbidities, and higher prevalence of moderate-severe left ventricular systolic dysfunction. Mortality was higher in the LRPV PCI group during hospital admission (12 % versus 1.5 %, P <0.001), at 30 days (15% versus 2%, P <0.001), and at one-year (24% versus 5%, P <0.001). In a propensity score matching analysis the adjusted risk of mortality during index admission (odds ratio, 2.05 [95% CI, 1.65–2.44], P <0.001), at 30 days (odds ratio, 2.13 [95% CI, 1.78–2.5], P <0.001), at 1 year (odds ratio, 1.81 [95% CI, 1.59–2.03], P <0.001), and in-hospital major adverse cardiovascular events (odds ratio, 1.8 [95% CI, 1.42–2.19], P <0.001) were higher in LRPV PCI group as compared to control group. In sensitivity analyses, similar clinical outcomes were observed irrespective of which major epicardial coronary artery was treated. Conclusions: In this contemporary cohort, patients who had PCI to their LRPV had a higher-risk profile and more adverse clinical outcomes, irrespective of the vessel treated.

scholarly journals Targeting elevated left ventricular end-diastolic pressure following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction – a phase one safety and feasibility study

2018 ◽  
Vol 9 (7) ◽  
pp. 758-763 ◽  
Author(s):  
Arshad A Khan ◽  
Allan J Davies ◽  
Nicholas J Whitehead ◽  
Michael McGee ◽  
Mohammed S Al-Omary ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Glyceryl Trinitrate ◽  
Primary Percutaneous Coronary Intervention ◽  
Diastolic Pressure ◽  
Intervention Group ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Control Group ◽  
St Segment Elevation ◽  
Percutaneous Coronary

Introduction: Elevated left ventricular end diastolic pressure (LVEDP) is an independent predictor of mortality and heart failure in patients with ST-segment elevation myocardial infarction (STEMI). Whether lowering elevated LVEDP improves outcomes remains unknown. Methods: This non-randomized, single blinded study with prospective enrolment and sequential group allocation recruited patients undergoing primary percutaneous coronary intervention for STEMI with LVEDP ⩾ 20 mmHg measured immediately after primary percutaneous coronary intervention. The intervention arm ( n=10) received furosemide 40 mg intravenous bolus plus escalating doses of glyceryl trinitrate (100 µg per min to a maximum of 1000 µg) during simultaneous measurement of LVEDP. The control group ( n=10) received corresponding normal saline boluses with simultaneous measurement of LVEDP (10 readings over 10 min). Efficacy endpoints were final LVEDP achieved, and the dose of glyceryl trinitrate needed to reduce LVEDP by ⩾ 20%. Safety endpoint was symptomatic hypotension (systolic blood pressure < 90 mmHg). Results: From 1 April 2017 to 23 August 2017 we enrolled 20 patients (age: 64±9 years, males: 60%, n=12, anterior STEMI: 65%, n=13). The mean LVEDP for the whole cohort ( n=20) was 29±4 mmHg (intervention group: 28±3 mmHg vs. control group: 31±5 mmHg; p=0.1). The LVEDP dropped from 28±3 to 16±2 mmHg in the glyceryl trinitrate + furosemide group ( p <0.01) but remained unchanged in the control group. The median dose of glyceryl trinitrate required to produce ⩾ 20% reduction in LVEDP in the intervention group was 200 µg (range: 100–800). One patient experienced asymptomatic decline in systolic blood pressure to below 90 mmHg. There was no correlation between LVEDP and left ventricular ejection fraction. Conclusion: The administration of glyceryl trinitrate plus furosemide in patients with elevated LVEDP following primary percutaneous coronary intervention for STEMI safely reduces LVEDP.

Effectiveness of Micro-class Mobile Teaching Video Method Combined with Psycho-cardiology Nursing in Postoperative Nursing for Coronary Heart Disease Patients Underwent Percutaneous Coronary Intervention and Training

2021 ◽  
Vol 7 (5) ◽  
pp. 4021-4032
Author(s):  
Tong Li ◽  
Qianli Sun ◽  
Qiyue Cui
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Control Group ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
Teaching Video ◽  
Experimental Group ◽  
And Training

Objective. To explore the effectiveness of micro-class mobile teaching video method combined with psycho-cardiology nursing in postoperative nursing for coronary heart disease (CHD) patients underwent percutaneous coronary intervention (PCI) and training. Methods. The clinical information of 120 patients underwent PCI admitted to our hospital (12.2018-12.2020) were retrospectively analyzed, and the patients were divided into the control group and the experimental group, with 60 cases each. Psycho-cardiology nursing was performed to the control group, and the micro-class mobile teaching video method was introduced to the experimental group on this basis to compare the application effect on postoperative nursing and training. Results. After nursing intervention, LVEF levels and ADL scores of both groups were increased, of which the experimental group were much higher (P all<0.05); the BNP levels and SAQ, HAMA and HAMD scores of both groups were decreased, of which the experimental group were much lower (P all<0.05); the problem-solving ability and satisfaction scores of the experimental group were higher than those of the control group (P<0.05); and the experimental group obtained a significantly lower incidence rate of adverse cardiac events in the between-group comparison (16.67% vs 3.33%, P<0.05). Conclusion. The combined therapy conducted to CHD patients underwent PCI has a good effect in postoperative nursing and training, can improve the patients’ cardiac function, reduce the angina severity, alleviate the anxiety and depression, promote the quality of life and problem-solving ability, and lower the incidence rate of adverse cardiac events, which is worthy of promotion and application.

scholarly journals The Efficacy and Safety of Nicorandil for Periprocedural Myocardial Injury in Patients Undergoing PCI: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Yuanxi Lu ◽  
Wenbiao Hu ◽  
Qinghua Song ◽  
Qiwu Wang
Keyword(s):  
Myocardial Injury ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Efficacy And Safety ◽  
Percutaneous Coronary ◽  
Early Use ◽  
Experimental Group ◽  
Periprocedural Myocardial Injury

Purpose. To evaluate the efficacy and safety of nicorandil for periprocedural myocardial injury in patients undergoing PCI through meta-analysis of randomized controlled trials. Methods. We analyzed the clinical data of patients including the incidence of periprocedural myocardial injury (PMI) and major adverse cardiovascular events (MACE) from selected articles. RCTs were retrieved from medical literature databases. RR and 95% confidence intervals (CI) were calculated to compare the endpoints. Results. In total, 15 articles (16 trial comparisons) were retrieved which contained 2221 patients. In general, 1130 patients (50.9%) were randomized to the experimental group, whereas 1091 patients (49.1%) were randomized to the control group. The result showed that nicorandil significantly reduced the incidence of PMI and MACE after PCI compared to the control group. Conclusions. Overall, early use of nicorandil in patients undergoing percutaneous coronary intervention (PCI) was associated with a significant reduction of PMI and MACE.

Effect of Alprostadil on the Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of 36 Randomized Controlled Trials

Angiology ◽  
2019 ◽  
Vol 70 (7) ◽  
pp. 594-612 ◽  
Author(s):  
Jian Xie ◽  
Mingyang Jiang ◽  
Yunni Lin ◽  
Huachu Deng ◽  
Lang Li
Keyword(s):  
Cystatin C ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Control Group ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary ◽  
Intrarenal Blood Flow ◽  
And Control ◽  
Experimental Group ◽  
Different Doses

Contrast-induced nephropathy (CIN) is the third leading cause of acquired acute renal injury in hospitalized patients. Alprostadil plays a role in the maintenance and redistribution of intrarenal blood flow and the excretion of electrolytes and water. However, the effectiveness of alprostadil in preventing CIN remains controversial. Thirty-six articles with a total of 5495 patients were included in this study. Both groups (experimental group and control group) received standard hydration therapy. In the experimental group, patients received different doses of alprostadil. Serum creatinine (SCr), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), cystatin C, creatinine clearance rate (CCr), and β2-microglobulin (β2-MG) were measured at 24, 48, and 72 hours after contrast media injection. The incidence of CIN in the experimental group was significantly lower than that in the control group (6.56% vs 16.74%). The level of SCr, cystatin C, BUN, and β2-MG in the experimental group was lower than those in the control group; CCr and eGFR in the experimental group were higher than those in the control group. This study demonstrated that alprostadil may reduce the incidence of CIN in patients undergoing coronary angiogram and/or percutaneous coronary intervention.

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