Prevention of Coronary Slow Flow or No-Reflow During PPCI in Patients With Acute STEMI

• Status: Unknown status
• Trial end date: 2019-12-31
• Target enrollment: 0
• Participant gender: All

Summary

Primary percutaneous coronary intervention (PPCI) is the gold standard of treatment of ST segment elevation myocardial infarction (STEMI).Slow flow / no-reflow phenomenon following PPCI in STEMI patients has been a serious and common complication that closely related to the incidence of major adverse cardiovascular events (MACE) and affected patients' prognosis. No reflow is a multi-factorial phenomenon. And its preventive and therapeutic effects are not satisfactory. This prospective randomized controlled study aimed to compare favorable effects of Nitroprusside versus Tirofiban on the prevention of slow flow / no-reflow phenomenon during PPCI.

• Phase: N/A
• Accepts Healthy Volunteers?: No

Details

• Lead Sponsor: The First Affiliated Hospital of Zhengzhou University
• Collaborators: Anyang Regional Hospital; First Affiliated Hospital of Xinjiang Medical University; Huaihe Hospital of Henan University; Jincheng People's Hospital; Jincheng People’s Hospital; Kaifeng Central Hospital; Lushan People's Hospital; Lushan People’s Hospital; Nanyang Central Hospital; People's Hospital of Zhengzhou University; Puyang Oil Field General Hospital; Puyang Oilfield General Hospital; Puyang People's Hospital; Shenma Medical Group General Hospital; The 99th Central Hospital of the People's Liberation Army; The First Affiliated Hospital of Henan University of Science and Technology; The First Affiliated Hospital of Xinxiang Medical University; The First People's Hospital of Shangqiu; The First People's Hospital of Xinmi; The First People's Hospital of Zhumadian; The Peoples' Hospital of Jiaozuo City; The second people's Hospital of Jiyuan; The Second People's Hospital of Pingdingshan; Xinyang Central Hospital; Yanshi People's Hospital; Yanshi People’s Hospital; Yellow River Sanmenxia hospital; Zhengzhou Cardiovascular Hospital; Zhengzhou Central Hospital; Zhengzhou First People's Hospital; Zhengzhou First People’s Hospital; Zhoukou Central Hospital; Zhumadian Central Hospital
• Treatments: Nitroprusside; Tirofiban

Criteria

Inclusion Criteria:

• Ischemic symptoms < 12h, or evidence of ongoing ischemia 12h after symptom onset

• Continued ischemic chest pain > 30min

• ST-segment elevation ≥ 0.1 millivolt in 2 or more contiguous leads on the 12-lead ECG or new left bundle branch block (LBBB)

• Detection of a rise of cardiac biomarker values with at least one value above the 99th percentile upper reference limit (URL)

• Primary coronary artery angiography was planned.

Exclusion Criteria:

• Emergency thrombolytic therapy was performed before primary coronary artery angiography

• Cardiogenic shock with no response to hypervolemic treatment or vasopressor

• Severe cardiomyopathy or valvular disease requiring intervention

• Coronary ectasia

• Severe heart failure

• Contraindication or allergy to antiplatelet drugs

• Contraindication or allergy to experimental drugs

• Unable to receive at least 1 year of dual antiplatelet therapy

• Active bleeding or extreme-risk for major bleeding

• Severe liver or renal failure

• Life expectancy < 1 year

• Unable or unwilling to provide informed consent

• Women of child bearing potential

• Under 18 years of age

• Hemoglobin < 90g/L

• Platelet count < 100×10^9/L

• Can not cooperate (with mental disorders or cognitive disorders)