Abstract: AIM: To compare the curative effect and safety of tirofiban before and during emergency PCI in patients with ST-segment elevated myocardial infarction(STEM). METHODS: Ninety patients with STEMI undergoing emergency PCI were randomized into three groups:tirofiban before PCI group (TBP group) (n=30,with early administration of tirofiban immediately in emergency department),tirofiban during PCI group (TDP group) (n=30,with administration of tirofiban in during PCI) and control group(n=30). TIMI flow,corrected TIMI frame count(CTFC),and ST segment resolution 90 min after PCI of three groups were compared. The incidences of bleeding complications and thrombocytopenia were registered to assess the safety.RESULTS: Compared with the control group,the CTFC and blood flow velocity in TBP and TDP groups were significantly improved (P<0.05), and the proportion of ST segment resolution was significantly higher. Compared with TDP group, the CTFC and blood flow velocity were significantly improved in TBP group (P<0.05). However, no significant difference was observed in major adverse cardiac events and bleeding in three groups.CONCLUSION: Early administration of tirofiban before emergency PCI improves myocardial reperfusion and reduces occurrence of slow-flow in patients undergoing primary PCI.

Key words: tirofiban, acute ST segment elevation myocardial infarction, emergency percutaneous coronary intervention