Effects of Glycoprotein Ⅱb/Ⅲa Inhibition on Myocardial Reperfusion Injury during Coronary Intervention in Elderly Patients

OBJECTIVE To evaluate the effect of platelet glycoprotein(GP) Ⅱb/Ⅲa receptor inhibitor on myocardial ischemical reperfusion injury (MIRI) during percutaneous coronary intervention(PCI) in elderly patients. METHODS We randomly assigned 141 elderly patients with acute coronary syndrome (ACS) either to routine drugs plus tirofiban (72 patients) or routine drugs plus placebo (69 patients) before they underwent PCI. Coronary angiography immediately afterward PCI and electrocardiogram (ECG) and ambulatory electrocardiography (AECG) and doppler echocardiography one week afterward PCI were evaluated. RESULTS In 141 patients undergoing PCI, MIRI was described by operators in 9(13.0%) patients and 2(2.8%) patients respectively. TIMI flow was significantly different in two groups (P<0.05). The incidence of myocardial infarction and arrhythmias and cardiogenic shock of the patients in control group was significantly higher. CONCLUSION As compared with placebo, GPⅡb/Ⅲa receptor inhibitor improves MIRI during PCI in elderly patients. This suggests GPⅡb/Ⅲa receptor inhibitor is an effective adjunctive therapy for MIRI, and that platelet mediated microvascular thrombus and embolization may be the mechanism of MIRI during PCI in elderly patients.