To explore the effect of early application of glycoprotein (GP)Ⅱb/Ⅲa antagonist on myocardial reperfusion in elderly patients with acute ST-elevation myocardial infarction (STEMI) taken coronary stenting.

Patients (n=52) from 2009 to 2014 in Department of Geriatrics, Xi'nan Hospital of Third Minitary Medical University, with a first onset of AMI receiving emergency coronary stenting were randomized to either early administration of tirofiban group which were admitted with tirofiban within 30min of admission (n=26) or later administration group which were given tirofiban after 30min of admission (n=26). The primary endpoints included the degree of TIMI flow and the percentage of ST segment depression at 90min, and 30-day major adverse cardiac events.T-test was utilized to compare between two groups, and kai-square test was applied to analyze the count data.

Angiographic analysis revealed a higher initial frequency of TIMI grade 3 flow in the early group (23% and 4%,χ²=4.13,P<0.05). Compared with the late group, the percentages of myocardial blush grade 3 (34.6% and 11.5%,χ²=3.90,P<0.05). The TIMI grade 3 and myocardial blush grade 3 before balloon ablation had no significant differences between the two groups (92.3% and 88.5%, 69.2% and 65.4%,χ²=0.22 and 0.09,P>0.05). ST segment depression at 90min in early group was significantly higher than in the later group (88.5% and 76.9%,χ²=1.21,P<0.05), and the surgery time in early group was significantly lower than the later group [(15±7) and (19±8)min,t=1.68,P<0.05). No 30-day death, recurrent MI or massive hemorrhage occurred in both groups. Two cases of minor hemorrhage in early group; one case of rehospitalization and 2 cases of minor hemorrhage in later group. No difference of cardiovascular events after discharge (8% and 12%,χ²=0.22,P>0.05).

The early administration of tirofiban could significantly improve myocardial reperfusion and clinical outcomes in aged patients of STEMI undergoing coronary stenting.