[Tirofiban improved the prognosis of senior acute coronary syndrome patients received percutaneous coronary intervention].

Abstract

OBJECTIVE:

To examine if tirofiban may improve the prognosis in aged acute coronary syndrome (ACS) patients received percutaneous coronary intervention (PCI).

METHODS:

Three hundred and twenty-five ACS patients (age ≥ 60 years), all received drug-eluting stents implantation, were assigned into tirofiban group (n = 210) to receive tirofiban+aspirin and clopidogrel and control group (n = 115) to received aspirin and clopidogrel only. The incidence of thrombolysis in myocardial infarction (TIMI) grade 3 after PCI, in-stent thrombosis, slight/severe bleeding, platelet decrease, myocardial infarction (MI) and target vessel revascularization (TVR) within 30 days and 12 months after PCI and 30 days and 12 months mortality post PCI.

RESULTS:

In comparison with the control group, the tirofiban group had significantly higher TIMI grade 3 flow after PCI (99.05% vs. 94.78%, P < 0.05), lower in-stent thrombosis (0.47% vs. 2.61%, P < 0.05), as well as lower mortality, MI, and TVR in 30 days and 12 months after PCI (30 days: 0, 0.47% and 0.47% vs. 2.61%, 3.48% and 2.61%; 12 months: 0, 0.47% and 0.47% vs. 2.61%, 5.22% and 5.22%, P < 0.05 or P < 0.01). No significant difference was found (both P > 0.05) in slight bleeding (7.14% vs. 4.35%) and severe bleeding (0 vs. 0) between tirofiban group and control group. A slight difference in thrombocytopenia was found between tirofiban group and control group (0.95% vs. 0), but it failed to reach the level of statistical significance (P > 0.05).

CONCLUSIONS:

Tirofiban may improve the TIMI grade flow in senior ACS patients after PCI. It also decreases the incidence of in-stent thrombosis, mortality, MI, and TVR in 30 days and 12 months after PCI, without causing increase in severe bleeding and platelet penia. Therefore, it may improve the short/long-term prognosis for these patients.

• Authors: Yu-xiao Zhang, Cai-yi Lu, Sheng-hua Zhou, Qiao Xue, Lei Gao, Jin-wen Tian, Wei Gao, Rui Chen, Jin-Yue Zhai, Li-Jun Li
• Journal: Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue (Zhongguo Wei Zhong Bing Ji Jiu Yi Xue) Vol. 23 Issue 12 Pg. 727-30 (Dec 2011) ISSN: 1003-0603 [Print] China
• PMID: 22153009 (Publication Type: Controlled Clinical Trial, Journal Article)

Chemical References

• Platelet Aggregation Inhibitors
• Tyrosine
• Clopidogrel
• Tirofiban
• Ticlopidine
• Aspirin

Topics

• Acute Coronary Syndrome (therapy)
• Aged
• Angioplasty, Balloon, Coronary (methods)
• Aspirin (therapeutic use)
• Clopidogrel
• Female
• Humans
• Male
• Middle Aged
• Platelet Aggregation Inhibitors (therapeutic use)
• Prognosis
• Ticlopidine (analogs & derivatives, therapeutic use)
• Tirofiban
• Tyrosine (analogs & derivatives, therapeutic use)