Preventive use of glycoprotein IIb/IIIa inhibitors in patients with ST-segment elevation myocardial infarction and a high risk of no-reflow phenomenon

Abstract

Aim: To evaluate the efficacy and safety of the preventive use of glycoprotein (GP) IIb/IIIa inhibitors in patients with ST-elevation myocardial infarction (STEMI) and a high risk of «no-reflow» phenomenon.Material and Methods. A total of 100 patients were included in the study. For all patients, the risk of no-reflow was calculated using a previously developed scoring system. In case of high risk, GP IIb/IIIa inhibitors were administered according to the decision of the interventional cardiologist. The rate of no-reflow as well as the rates of death, recurrent myocardial infarction and stent thrombosis were analyzed.Results. High risk of no-reflow was determined in 37 patients, low risk of no-reflow – in 63 patients. In the high-risk group 22 patients (59.5%) GP IIb/IIIa inhibitors were preventively used. In these patients, the frequency of no-reflow was lower compared with high-risk patients who did not receive preventive GP IIb/IIIa inhibitors (9.1 vs. 46.7%, p = 0.017). With the preventive use of GP IIb/IIIa inhibitors in high-risk patients, the rates of no-reflow (9.1 vs. 11.1%, p = 1.000) and angiographic success of percutaneous coronary intervention (72.7 vs. 84.1%, p = 0.341) were comparable with low-risk patients.Conclusion. The preventive use of GP IIb/IIIa inhibitors in patients with STEMI and a high risk was associated with reduction of «no-reflow». In the prophylactic use of GP IIb/IIIa inhibitors in patients with STEMI and a high risk of no-reflow, the results of their treatment were comparable to patients with a low risk of no-reflow.