Investigation of the efficacy and safety of tirofiban in elderly patients with acute myocardial infarction referred for percutaneous coronary intervention / 中华老年医学杂志

ABSTRACT

Objective To evaluate the efficacy and safety of use of platelet membrane glycoprotein (GP) Ⅱ b/Ⅲ a inhibitor tirofiban for percutaneous coronary interventional (PCI) in elderly patients with acute ST segment elevation myocardial infarction (STEMI).Methods A total of 120 elderly patients who suffered from STEMI and underwent PCI were selected from July 2007 to November 2009.The patients were randomly assigned to control group, standard-dose tirofiban group and low-dose tirofiban group.We observed coronary blood reflow, the bleeding complication, coagulation factor(TF,vWF) and cell adhesion molecular(sICAM-1 and sVCAM-1).Results Total 116 patients accomplished this study (control group 38 cases; standard-dose group 39 cases; low-dose 39 cases).The percentages of TIMI 3 flow after PCI were higher in the two tirofiban groups than in control group (P<0.05).The incidences of bleeding complications in both tirofiban groups (12.8%,5.1%) were higher than that in control group (2.6%, P<0.05).The concentration of TF, vWF,sICAM-1 and sVCAM-1 were lower in both tirofiban groups than in control group(P< 0.05).Conclusions GP Ⅱ b/Ⅲ a inhibitor tirofiban can benefit the elderly patients with STEMI referred for PCI therapy, low-dose tirofiban may offer almost the same level of efficacy as standard-dose, with less associated bleeding.