Turk Kardiyol Dern Ars. 2005; 33(4): 204-211

The effect of glycoprotein IIb/IIIa inhibition on ST-segment resolution following successful primary percutaneous coronary interventions

Hüseyin Uyarel¹, İsmail Erdem¹, Şennur Ünal Dayi¹, Hülya Kaşıkçıoğlu¹, Zeynep Tartan¹, Özgür Akgül¹, Dilek Şimşek¹, Ahmet Karabulut¹, Muhammed Gürdoğan¹, Ertan Ökmen¹, Neşe Çam¹

OBJECTIVES
We evaluated the effect of glycoprotein (GP) IIb/IIIa receptor inhibition on ST-segment resolution in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (MI).
STUDY DESIGN
We retrospectively analyzed 115 patients (96 males, 19 females; mean age 57.7 years; range 39 to 82 years) who presented with ST-segment elevation acute MI and treated within 12 hours with successful primary PCI (TIMI III flow). Of these, a GP IIb/IIIa receptor blocker (tirofiban) was used in 64 patients. The arithmetic sum of ST-segments was obtained in millimeters on electrocardiograms immediately before angioplasty and after 60 minutes of TIMI III flow restoration. The difference between the two measurements was accepted as resolution of the sum of ST-segment elevation and expressed as ?STR.
RESULTS
There were no significant differences between the two treatment groups regarding age, gender, cardiovascular risk factors, laboratory parameters, duration from angina onset to emergency service and from door to angioplasty. Patients who received tirofiban had a greater ?STR than those who did not (7.2±2.8 mm vs 4.2±2.6 mm, respectively; p<0.001). A significant and positive correlation was seen between GP IIb/IIIa inhibition and ?STR (r=0.336, p<0.001). In a multivariate linear regression model including nine variables, GP IIb/IIIa inhibition was found as the only independent determinant of ?STR (p<0.001).
CONCLUSION
Glycoprotein IIb/IIIa inhibition helps preserve microvascular perfusion in patients with TIMI III flow after primary PCI.

Keywords: Angioplasty, transluminal, percutaneous coronary; coronary circulation/drug effects; myocardial infarction/drug therapy; myocardial reperfusion/methods; platelet aggregation inhibitors; platelet glycoprotein GPIIb-IIIa complex

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