Application effect and influence of low-dose tirofiban on perioperative period of PCI and prognosis in patients with non-ST-segment elevation acute coronary syndromes
Yuan Chaobo
Zhao Lihua
Zhang Peiyong
Duan Penghong
Guo Changlei
Abstract：Objective To observe the application effect and influence of low-dose tirofiban on perioperative period of PCI and prognosis in patients with non-ST-segment elevation acute coronary syndromes(NSTE-ACS).Methods NSTE-ACS patients(n=685)were selected from the First Affiliated Hospital of Xinxiang Medical University from Jan.2021 to Dec.2022,and divided into control group(n=217),routine-dose group(n=233)and low-dose group(n=235).The control group was given aspirin combined with clopidogrel,and routine-dose group and low-dose group were additionally given tirofiban(10 μg/kg,5 μg/kg).After the operation for 36 h,routine-dose group and low-dose group were given tirofiban by intravenous pumping(0.15 μg/kg·min,0.07 μg/kg·min).The status of TIMI blood flow grading and no-reflow(NR)of infarct-related artery(IRA)were compared among 3 groups after the operation.The heart function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],blood biochemistry indexes[cardiac troponin I(cTnI),high-sensitivity C-reactive protein(hs-CRP)]before and 1 week after the operation,and bleeding adverse events and occurrence of major adverse cardiovascular events(MACE)within 12 months after the operation were compared among 3 groups.Results The difference in TIMI blood flow grades had statistical significance in routine-dose group and low-dose group compared with control group(P＜0.05).The levels of NR,LVEDD,cTnI and hs-CRP were lower(P＜0.05),and LVEF was higher(P＜0.05)in routine-dose group and low-dose group than those in control group,and difference had no statistical significance between routine-dose group and low-dose group(P＞0.05).There was no serious bleeding event in 3 groups,and bleeding incidence was significantly lower in low-dose group than that in routine-dose group(P＜0.05),and had no statistical significance compared with control group(P＞0.05).The total incidence of MACE was significantly lower in low-dose group than that in control group(P＜0.05),and had no statistical significance compared with routine-dose group(P＞0.05)within 12 months after the operation.Conclusion The application of low-dose tirofiban can improve postoperative hemodynamic status,and reduce myocardial injury and MACE risk in NSTE-ACS patients,and their prognosis is comparable to those with routine-dose tirofiban but bleeding risk is significantly reduced.
Keywords：TirofibanNon-ST-segment elevation acute coronary syndromesPercutaneous coronary interventionMajor adverse cardiovascular events
Publication Date：2025-04-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 448-451,456 )