Muhammad Nawaz Lashari, Muhammad Tanveer Alam, Tariq Ashraf, Mukhtiar Ahmad Pathan.
Efficacy of Intracoronary Bolus administration of Tirofiban in Acute Coronary Syndrome Patients with No-reflow Phenomenon during Percutaneous Coronary intervention (PCI).
Med Forum Jan ;3(3):6-9.

Objective: Currently in acute coronary syndrome, PCI is most common strategy. No-reflow phenomenon (NR) is one of serious complication. Aim of this study was to evaluate role of intracoronary bolus administration of tirofiban in acute coronary syndrome patients with no-reflow during PCI. Study Design: It is prospective and observational study. Place and Duration of Study: It is multicenter study, conducted in Karachi, Pakistan from August 2011 to July 2013. Patients and Methods: Total of 62 patients of acute coronary syndrome underwent for PCI and developed no-reflow, received intracoronary bolus tirofiban were included. The angiographic definition of successful reperfusion should include both TIMI 3 flow as well as MBG 2 or 3. No-reflow, assesed by thrombolysis in myocardial infarction (TIMI) flow and myocardial blush grade (MBG) during treatment. Data were entered and analyzed using SPSS-16 software. Statistical significance was defined as p-value <0.05. Results: Out of 62 patients, 43 were males .The mean age was 51 ±13, range from 37 to 70 years. TIMI flow 1 and 11 seen in 17, 37 patients while MBG 1 and 11 seen in 20 and 33 patients before intracoronary bolus administration of tirofiban. After bolus administration of tirofiban, TIMI flow 111 was seen in 61(98.387 %) out of 62 patients while MBG 11 and 111 was also noted in 61(98.387 %) out of 62 patients. It showed better Thrombolysis In Myocardial Infarction flow grades and TIMI myocardial perfusion grades (OR 0. 22, 95% CI 0 .12 -0 .39, p-value <0.001) immediately after intracoronary bolus administration of tirofiban in reflow phenomenon patients during PCI. Conclusion: In patients with ACS, Intracoronary bolus adminstration of tirofiban is effective drug to improve no-reflow during percutaneous coronary intervention especially when patient blood pressure is at lower-side.

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