Tirofiban in percutaneous coronary intervention of patients with acute non-ST segment elevation myocardial infarct: Safety and efficacy / 第二军医大学学报

ABSTRACT

Objective: To evaluate the efficacy and safety of tirofiban, a platelet glycoprotein IIb/ IIIa Inhibitor, in percutaneous coronary intervention (PCI) of patients with acute non-ST segment elevation myocardial infarct (NSTEMI). Methods: A total of 114 patients with acute NSTEMI were enrolled in the trial from Sep. 2005 to Jan. 2007; they were randomly divided into 2 groups tirofiban group (n=57) and placebo group (n=57). Patients in tirofiban group were given tirofiban for 24 h after PCI. All patients were routinely given heparin, aspirin and clopidogrel before CPI. The composite occurrence of death, myocardial infarction (MI), need for target vessel revascularization (TVR) after PCI, and the adverse effects (hemorrhage and thrombocypenia) were compared between the 2 groups. Results: One (1.8%) patient had angina pectoris and the other (1.8%) developed subacute thrombus in control group within 24 h after PCI; there was no such event in the tirofiban group. Two (3.6%) patients developed angina pectoris and 2 (3.6%) developed subacute thrombus within 30 days after PCI in control group; one patient (1.8%) in birofiban group developed angina pectoris and one patient in birofiban group developed subacute thrombus. Each group had one case (1.8%) of upper digestive tract bleeding during hospitalization. No intracranial hemorrhage, skin/mucosa hemorrhage, thrombocytopenia, or death occurred in the 2 groups. Intravenous tirofiban treatment reduced the composite occurrence of death of NSTEMI patients after PCI (P<0.05). There was no significant difference in occurrence of complications such as intracranial hemorrhage, skin/mucosa hemorrhage, or thrombocytopenia between the 2 groups. Conclusion: Intravenous tirofiban treatment after PCI can reduce the composite occurrence of death, MI, and need for TVR without increasing the adverse reactions of the drugs; it is safe and effective in patients undergoing early coronary stenting.