Effect of upstream application of tirofiban in patients with moderate-high risk non-ST elevation acute coronary syndrome
Abstract：Objective To analyze the clinical effect of upstream application of tirofiban in patients with moderate-high risk non-ST acute coronary syndrome (NSTACS).Methods Totally 182 patients with NSTACS who received elective percutaneous coronary intervention(PCI) from May 2009 to July 2010 were randomly divided into observation group (80 cases) given upstream application of tirofiban (before PCI) and control group(102 cases) given tirofiban from the onset of PCI.The characteristics of coronary lesions,stenting implantation,flow perfusion of the culprit vessel (CV),creatine kinaseand cardiac troponin Ⅰ (cTNI) in serum,major adverse cardiovascular events (MACE) in hospital and 30 days after PCI,haemorrhage were observed and compared between the two groups.Results The access site,degree of stenosis,proportion of multivessel lesion,proportion of chronic occlusion lesion,proportion of long lesion (＞ 20 mm),proportion of bifurcation lesion,proportion of thrombotic lesion,stent number,stent diameter,stent length had no statistical differences between the two groups (P ＞ 0.05).The pre-and postoperative thrombolysis in myocardial infarction (TIMI) flow grade and preoperative TIMI myocardial perfusion grade (TMPG) showed no significantly differences between the two groups (P ＞ 0.05);the proportion of TMPG ＜ 3 in observation group was significantly lower than that of control group [6.2％ (5/80) vs 15.7％ (16/102)] (P ＜ 0.05).The level of serum creatine kinase and cTNI 48 h after operation were significantly decreased compared with those before operation in observation group[(5 ±4) U/L vs (21 ± 10) U/L,(0.8 ±0.4) μg/L vs (4.0 ± 1.7) μg/L] and control group [(9 ± 3) U/L vs (20 ± 11) U/L,(1.1 ± 0.9) μg/L vs (4.6 ± 1.8) μg/L],also being significantly different between the two groups (P ＜ 0.05).No MACE occurred in both groups.No significant difference of incidence of haemorrhage was found between the two groups (P ＞ 0.05);after stopping or reducing the dose of tirofiban,the haemorrhage symptom disappeared and no serious haemorrhage was observed.Conclusion Upstream using of tirofiban may improve myocardial perfusion of CV,without increasing the incidence of haemorrhage in patients with moderate-high risk NSTACS receiving PCI.
Keywords：Myocardial infarctionTirofibanMyocardial perfusionPercutaneous coronary intervention
Publication Date：2015-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1096-1100 )