Abstract

Challenges remain for clinicians over balancing the efficacy of active antithrombotic therapy and simultaneous bleeding reduction in patients. The clinical data of 347 patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) were retrospectively analyzed. On the basis of the given tirofiban, the patients were assigned into three different dose groups: high dose group (group H), medium dose group (group M), and low dose group (group L). The tirofiban efficacy was evaluated in terms of major adverse cardiovascular event (MACE) parameters and lab endpoints, including platelet count and function. The tirofiban safety was assessed by the occurrence of bleeding events. The patients were followed up for 1 month after the PCI. No significant difference in MACE events was evident among these groups (p > 0.05). Groups H and M reported an obvious reduction in platelet count (p < 0.05 for both) and an increased platelet inhibition rate (p < 0.05 for both). Group H showed a higher rate of total bleeding events than the other groups (Group H vs. Group M: 34.4% vs. 16.5%; Group H vs. Group L: 34.4% vs. 10.3%; p < 0.05 for both). A proper administration of a low dose of tirofiban may be a superior alternative in treating ACS patients, which can produce a similar favorable clinical outcome and a decrease in bleeding complication.

Highlights

  • MethodsA short-term, single-center, retrospective study was designed to evaluate the efficacy and safety of a multi-dose tirofiban treatment for 3,871 consecutive acute coronary syndrome (ACS) patients from July 2015 to September 2019

  • Acute coronary syndrome (ACS) is an increasingly prevalent condition in the elderly population w­ orldwide[1]

  • The patients were examined for acute ST-segment elevation myocardial infarction (STEMI), non-acute ST-segment elevation myocardial infarction (NSTEMI), and unstable angina pectoris (UA)

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Summary

Methods

A short-term, single-center, retrospective study was designed to evaluate the efficacy and safety of a multi-dose tirofiban treatment for 3,871 consecutive ACS patients from July 2015 to September 2019. Demographics Age (years) Male, n (%) Smoker, n (%) Body-mass index (kg/m2) Duration time (hours) CYP2C19 gene Slow, n (%) Middle, n (%) Rapid, n (%) Medical history Gastrointestinal bleeding, n (%) Hematencephalon, n (%) Hypertension, n (%) Hyperlipidemia, n (%) Diabetes mellitus, n (%) Atrial fibrillation, n (%) Fibrinolytic therapy, n (%) ACS classification STEMI, n (%) NSTEMI, n (%) UA, n (%) Infarct-related artery Left main coronary artery, n (%) Anterior descending, n (%) Circumflex artery, n (%) Right coronary artery, n (%) Drug information Dual antiplatelet (aspirin + clopidogrel), n (%) Oral anticoagulant, n (%) Statin, n (%) ACEI/ARB, n (%) β-blocker, n (%) MACE, n (%). Informed consent was obtained from all individual participants included in the study

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