Health Condition 1: O- Medical and Surgical
Conditions
Interventions
Intervention1: Intracoronary Tirofiban: 70 STEMI patients over a duration of 18 months with IMR more than 31 after PCI will be divided into two groups after randomization. Group 1 will receive stat In
Sponsors
Govt Medical College and Hospital Chandigarh
Eligibility
Inclusion criteria
Inclusion criteria: 1. Adult men and women aged over 18 yr and less than 75 yr who present with STEMI within 12 hours of symptom onset and are hemodynamically stable. Patients will be eligible if they have symptoms consistent with myocardial ischemia (chest pain, dyspnea) for at least 20 minutes accompanied by definite ECG changes indicating STEMI as defined by ACC/AHA guidelines. 2. Successful reperfusion of infarct-related artery with restoration of epicardial flow. 3. Willing and able to comply with all study requirements, including treatment, assessment, and clinic visit attendances.
Exclusion criteria
Exclusion criteria: 1. Previous MI/PCI/coronary bypass grafting (CABG) in the culprit vessel. 2. Other distal residual lesions with more than 50 percent diameter stenosis in the culprit vessel. 3. Presence of contraindications to study drugs. 4. Presence of contraindications to adenosine infusion for IMR measurement, including sinus node disease, moderate to severe bronchospastic disease, and second or third-degree atrioventricular (AV) block 5. Active malignancy 6. Concurrent illness, including severe infection that may jeopardize the ability of the patient to undergo the procedures outlined in this protocol, with reasonable safety 7. Serious medical or psychiatric conditions 8. Pregnancy or lactation (At time of PCI) 9. Patients who received GpIIb/IIIa treatment prior to IMR measurement. 10. Patients who do not undergo primary PCI due to the lack of severity of the culprit lesion or other reasons, like cardiogenic shock requiring mechanical circulatory support.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change in IMR after Intracoronary Tirofiban versus Intracoronary Nitroglycerin among patients with IMR more than 31Timepoint: At baseline, 5 minutes after intracoronary drug administration | — |
Secondary
| Measure | Time frame |
|---|---|
| 1.To correlate IVUS lesion morphology with IMR and angiographic slow-flow/no-reflow in STEMI patients undergoing Primary PCI to study predictors of MVO. 2. To correlate IMR with TIMI flow, Myocardial blush grade (MBG), & ST-segment resolution 2 hours post PCI 3. To evaluate in-hospital & short-term clinical outcomes at 30 days (Major Adverse Cardiovascular Events & change in Left Ventricle Ejection Fraction)Timepoint: IVUS will be done before stenting. TIMI flow & Myocardial Blush Grade will be done during the index procedure. ECG will be done 2 hours after PCI. Clinical outcomes (MACE & 2D-ECHO) will be assessed in the hospital & at 30 days | — |
Countries
India
Contacts
Public ContactDeepanshu
Govt. Medical College and Hospital, Sector 32, Chandigarh
Outcome results
None listed