Comparison in myocardial perfusion between the intracoronary versus intralesional eptifibatide administration during primary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction; A randomized clinical trial

Objectives: This study aims to comparison of Eptifibatide localized injection and intracoronary injection on the myocardial perfusion improvement and its outcomes. Design:The study is a randomized clinical trial,That will be done for 60 patients with thrombotic AMI. Setting and conduct: The patients will be undergoing percutaneous coronary intervention (PCI) and will be randomly(by using random number table method) dived into two equal number groups. Inclusion criteria: Diagnosis of ST elevation myocardial infarction as defined by chest pain suggestive for myocardial ischemia for at least 30 minutes before hospital admission; these patients should also have three or more thrombus burden grade on the angiography; undergoing PCI; The consent of patients or their families to participate in the study; insensitivity to Eptifibatide. Exclusion criteria: Rescue PCI after thrombolytic therapy; Contraindications for antiplatelet; thrombocytopenia; recent stroke (less than 6 months) and cardiogenic shock. Intervention: The first group will be receiving two bolus doses (180 Microgram / kilogram) of Eptifibatide through guiding catheter. The second group will be receiving the same bolus doses through export aspiration catheter into the coronary lesion directly. Main outcome measures variables: Thrombolysis in myocardial infarction flow, myocardial blush grade and no-reflow phenomenon will primary end points. Secondary end points will pre and post-procedure cardiac arrhythmia, in-hospital mortality, adverse effects, reinfection, pre-discharge ventricular systolic function and re hospitalization and mortality after 6 month follow up.

Isfahan University of Medical Sciences