Perioperative safety and effectiveness of tirofiban bridging DAPT in elderly patients with pre-IIIa lung cancers complicated by coronary heart disease underwent resection after stent implantation
Zhao Shasha
Wang Zhonglu
Abstract：Objective To investigate the safety and effectiveness of tirofiban bridging dual anti-platelet therapy(DAPT)in elderly patients with pre-IIIa lung cancers complicated by coronary heart disease(CHD)underwent cancer resection after new-generation drug-eluting stents(DES)implantation within 3 months.Methods The patients(n=131)underwent cancer resection after new-generation DES implantation within 3 months were selected from Beijing Chest Hospital affiliated to Capital Medical University from July 2017 and June 2024.All patients were continuously given tirofiban(0.05 μg/kg·min).After cancer resection without significant bleeding events,DAPT was bridged in the patients(maintenance dose+loading dose)within 24 h.The symptoms,activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),platelet count(PLT),hemoglobin(Hb),fecal occult blood(FOB)and electrocardiogram(ECG)were monitored every day during medication.Results DAPT was applied in 131 patients,and there was no in-stent thrombosis event(0%).During bridging period,there were 5 cases of mild bleeding(3.8%,unilateral 95%CI:0.5%～7.1%),including 1 case of epistaxis,1 case of gum bleeding and 3 cases of subcutaneous hemorrhage.The results of repeat thoracotomy showed that chest drainage volume>1.5 L and Hb infusion unit≥4.There was no case of in-stent thrombosis-related death or all cause death.Conclusion The strategy of pre-operative tirofiban bridging DAPT has higher perioperative safety and effectiveness in elderly patients with pre-IIIa lung cancers complicated by CHD underwent cancer resection after DES implantation within 3 months.
Keywords：Lung cancersCoronary heart diseaseTirofibanDual anti-platelet therapyBridging
Publication Date：2025-03-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 347-350 )