To evaluate the safety and efficacy of
tirofiban, a specific inhibitor of the
platelet glycoprotein llb/llla receptor, in the treatment of
unstable angina and
myocardial infarction without persistent ST elevation (
acute coronary syndrome, ACS), a total of 200 patients were randomly assigned to a
heparin group and a tirofiban+heparin group on double-blind basis and the treatment effects of the two protocols on ACS were compared when the patients of both groups were taking
aspirin at the same time. The composite primary end-point events consisted of death,
myocardial infarction, or refractory
ischemia. Our results showed that the frequency of the composite primary end point events in 30 days was lower in tirofiban+heparin group as compared with that of
heparin group (13.9% vs 29.3 %, P=0.010). The rates of the other composite end point events in the tirofiban+heparin group were also lower than those in the
heparin group in 4.5 days and in 30 days.
Bleeding complication occurred in 7.0% of the patients receiving
heparin alone and in 12.7% of the patients receiving
tirofiban and
heparin in combination (P=0.1717). The study showed that the incidence of ischemic events in patients with ACS receiving tirofiban+heparin was lower when compared with that of patients who received only
heparin and
aspirin, suggesting that
tirofiban might be of special value in the treatment of ACS.