Intensive treatment with tirofiban combining clopidogrel in different doses in patients with NSTE-ACS during perioperative period
Wang Chulin
Xu Mingwei
Wu Qiang
Lin Yupeng
Chen Xiaoying
Shen Ning
Abstract：Objective To compare the clinical efficacy of tirofiban combining clopidogrel in different doses in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) during perioperative period. Methods NSTE-ACS patients (n=100, male 54 and female 46) prepared to undergo percutaneous coronary intervention (PCI) were chosen from the People's Hospital of Jieyang City from Oct. 2013 to Apr. 2016, and randomly divided into group A and group B (each n=50). All patients in 2 groups were given anti-platelet therapy (aspirin and clopidogrel) before and after PCI. Group A was given tirofiban (10.0 μg/kg) by intracoronary injection during the operation, and then by continuous intravenous pumping [0.15 μg/(kg·min)] for 12 h to 48 h. Group B was given tirofiban (5.0 μg/kg) by intracoronary injection within 3 min during the operation, and then by continuous intravenous pumping [0.075 μg/(kg·min)] for 12 h to 48 h. The flow grades of thrombolysis in myocardial infarction (TIMI) were reviewed before and after PCI. The patients were given color ultrasound examination for detecting left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD) and left ventricular end-diastolic inner diameter (LVEDD) before and 1 m after PCI. The adverse cardiovascular events were counted within 1 m after PCI. Results The percentage of patients with grade 0 and grade 1 of TIMI flow grading decreased, and percentage of patients with grade 3 increased in group A and group B after treatment (all P<0.05). The percentage of patients with grade 3 of TIMI flow grading increased in group A compared with group B (76.0% vs. 52.0%, P<0.05). The indexes of LVEF, LVESD and LVEDD were improved in 2 groups after treatment (all P<0.05). The indexes of LVEF, LVESD and LVEDD were improved more significantly in group A compared with group B (all P<0.05). The incidence of adverse cardiovascular events was 4.0% in group A and 16.0% in group B (P<0.05). Conclusion The whole-dose tirofiban combining clopidogrel has more advantages than half-dose tirofiban combining clopidogrel in treatment of NSTE-ACS during perioperative period, which is more effective in improving heart function and blood flow and reducing incidence of adverse cardiovascular events with higher safety. It is well worth clinical application.
Keywords：TirofibanClopidogrelNon-ST-segment elevation acute coronary syndromesIntensive treatment
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 316-318 )