Overview

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)