Study of low-dose tirofiban in the treatment of acute ST-segment elevation myocardial infarction in elderly women underwent primary PCI

Wang Yuhong; Shi Yujie; Xu Wei; Li Junxia; Niu Lili

doi:10.3969/j.issn.1674-4055.2018.05.28

Abstract：Objective To evaluate the effectiveness and safety of small dose tirofiban therapy for old female ST segment elevated acute myocardial infarction(STEMI) patients underwent primary percutaneous coronary intervention (PCI). Methods 87 old female STEMI patients who received primary PCI in PLA Army General Hospital were randomly assigned into normal dose group (n=41) and low dose group (n=46). After an intravenous injection of bolus dose tirofiban (25 ug/kg), the patients received 0.15 ug/kg. min (normal dose group) or 0.05 ug/kg. min (low dose group) intravenous injection for 12 hours. All patients were followed-up for 12 months. The primary end points were major adverse cardiac events and major bleeding rate. The secondary end points were TIMI 3 blood flow rate immediately after PCI and minor bleeding rate. Results Compared with normal dose group, the low dose group had same TIMI 3 blood flow rate immediately after PCI (76.1% vs. 78.1%, respectively; P=0.83). Low dose group had a significantly lower rate of bleeding complication than normal dose group (21.7% vs. 46.3%, respectively;P=0.02). The major bleeding rate were not statistically different between two groups (8.7% vs. 14.6%, respectively, P=0.39). The minor bleeding rate of low dose group was significantly lower than that of normal dose group (13% vs. 31.7%, P=0.04). During the 12-month follow up, the MACE rates between two groups were not statistically different (41.3% vs. 43.3%, P=0.75). Conclusion Compared with normal dose, low dose tirofiban use during the primary PCI has a similar immediate coronary blood flow recovery and MACE rate during 12-month follow-up with a significantly lower bleeding events rate.