Effect and safety of additional tirofiban for aspirin resistance patients with acute coronary syndrome

Abstract

Objective To evaluate the safety and efficacy of use of Tirofiban in non-interventional treatment for aspirin resistance(AR)patients with acute coronary syndrome(ACS).Methods 128 patients with ACS(unstable angina and non-Q-wave myocardial infarction)were divided into two groups:63patients in the control- group(aspirin plus clopidogrel)and 65 patients in the Tirofiban group(10 microg/ kg within 3 minutes followed by Tirofiban 0.15 microg /kg.min intravenous maintenance infusion with micro pump for 36 hours plus aspirin plus clopidogrel).The clinical data were recorded and analyzed,including clinical characteristics,main adverse cardiac events(MACE)such as recurrent angina,myocardial infarction and target vessel revascularization,and the adverse effects such as sudden death,hemorrhage and thrombocytopenia.Results No MACE occurred in two groups within 36 hours after administration.In the Tirofiban group,no recurrent angina and myocardial infarction occurred,in control-group 2 patients occurred recurrent angina but no myocardial infarction.In another case within 30 days after administration,while in the control- group,recurrent angina occurred in 5patients and 2 patients occurrence of myocardial infarction.No death and target vessel revascularization occurred in the both groups.There were 2cases of minor bleeding in Tirofiban group within 36 hours after administration,and no major bleeding and thrombocytopenia till 30 days after administration.No significant difference was found in MACE occurrence and adverse effects between the two groups(P＞0.05).Conclusions When administered with heparin and aspirin,tirofban was associated with a lower incidence of recurrent angina and myocardial infarction but no higher incidence of hemorrhage and thrombocytopenia in patients with acute coronary syndromes than inpatients who received only aspirin plus clopidogrel. Key words: Tirofiban; Aspirin resistance; Acute coronary syndrome