Tirofiban Research Articles

Antiplatelet regimen following stent-assisted embolization for intracranial aneurysms

Objective To investigate the efficacy and safety of one antiplatelet regimen following stent-assisted embolization for intracranial aneurysms. Methods Clinical data were analyzed retrospectively in 684 patients with intracranial aneurysms who underwent stent-assisted embolization from July 2014 to July 2016 at Wuhan General Hospital of the Chinese Liberation Army. Tirofiban hydrochloride was injected immediately after stent deploying and infused continuously by micro-pump for 24 hours. Dual antiplatelet therapy (aspirin 100 mg/d + clopidogrel 75 mg/d) started on the second day. Postoperatively, the platelet activation function was dynamically monitored by flow cytometry. The dose adjustment criteria of antiplatelet drugs were based on the platelet inhibition status (the positive rate of CD62P after adenosine diphosphate activation was below 20%) and specific postoperative conditions such as hemorrhage or ischemia for 486 cases (passive adjustment group) before June 2015, and those for 198 cases (active adjustment group) after June 2015 were only according to the platelet inhibition status regardless of hemorrhage or ischemia. Results Complications were reported in 67 out of 684 (9.8%) cases and included aneurysm rerupture (n=23, 3.4%), hydrocephalus requiring ventriculoperitoneal shunting (n=13, 1.9%), stent thrombosis (n=9, 1.3%), cerebral infarction (n=6, 0.9%), intracranial hemorrhage in remote areas (n=4, 0.6%), plaque shedding (n=2, 0.3%) cases, aneurysm recurrence (n=3, 0.4%) and death (n=26, 3.8%). The medication regimen was adjusted in a total of 221 (32.3%) patients including 147 (30.2%, 147/486) cases in the passive adjustment group and 74 (37.4%, 74/198) cases in the active adjustment group. There was significant difference in the complication rate of hemorrhage between passive and active adjustment groups (9.1% [44/486] vs. 3.5% [7/198], P<0.05). No significant difference was identified in the complication rate of ischemia between the two groups (0.2% [1/462] vs. 1.0% [2/196], P=0.19). Transient ischemic attack occurred in 3 (0.4%) cases during the process of dose reduction of clopidogrel which remitted following the dose increase. No case of resistance to antiplatelet therapy was found. Conclusion Antiplatelet therapy regimen guided by platelet activation assay could be useful for preventing thrombosis and hemorrhagic events following stent-assisted embolization for intracranial aneurysms. Key words: Intracranial aneurysm; Aneurysm, ruptured; Embolization, therapeutic; Stents; Platelet aggregation inhibitors; Coil

Effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level

Objective To investigate the effect of tirofiban hydrochloride in the treatment of coronary heart disease and its influence on homocysteine level. Methods 92 patients with coronary heart disease were selected as research subjects.They were randomly divided into the observation group and the control group, 46 cases in each group.The control group was treated with anti-thrombotic, nitrates and other conventional western medicine.The observation group was treated with tirofiban hydrochloride based on the conventional treatment. Results The total effective rate of the observation group was 95.65%, which was higher than 82.61% of the control group, the difference was significant (χ2=4.039, P<0.05). And the homocysteine level in the observation group was (5.38±1.02)μmol/L, which was lower than (7.27±1.19)μmol/L in the control group, the difference was statistically significant (t=8.179, P<0.01). After treatment, the cardiac function CO level[(4.96±0.98)L/min], EF level[(62.48±11.16)%]and SV level[(86.37±11.47)mL]in the observation group were higher than those in the control group, the differences were statistically significant (t=2.271, 2.954, 2.911, all P<0.05). After treatment, the hs-CRP level[(4.25±1.32)mg/L]and Fib level[(3.14±0.73)g/L] in the observation group were lower than those in the control group, the differences were statistically significant (t=7.981, 3.174, all P<0.01). Conclusion Tirofiban hydrochloride in the treatment of coronary heart disease can effectively contribute to the reduction of homocysteine levels and alleviate atherosclerosis lesion progression, not only can reduce severity of myocardial ischemia and fibrinogen and high-sensitivity C-reactive protein levels, but also can reduce the thrombosis and inflammation produced by the degree of harm to the patients. Key words: Coronary artery disease; Tirofiban hydrochloride; Homocysteine; C-reactive protein; Fibrinogen

Effects of combination therapy of tirofiban and reteplase on endothelial function, coagulation function and inflammatory factors in elderly patients with acute ST-segment elevation myocardial infarction

Objective To investigate the effect of the combination therapy of tirofiban and reteplase on endothelial function, coagulation function and plaque inflammation in elderly patients with ST-elevation acute myocardial infarction (STEMI). Methods 100 patients with STEMI were treated with percutaneous transluminal coronary intervention (PCI) from January 2014 to June 2016 in our hospital.39 cases in the control group used conventional oral aspirin, clopidogrel and statins and other treatment.61 cases in the observation group received tirofiban and reteplase on the basis of the control group.The expression of endothelial microparticles (EMP) was detected by flow cytometry (FCM), and the ICAM-1, high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor α(TNF-α) and interleukin-6 (IL-6), endothelin-1(ET-1) were measured by enzyme-linked immunosorbent assay (ELISA). The thrombin time (TT), activated partial thrombin time (APTT), prothrombin time (PT) and other indicators were measured by PUN-2048A coagulation instrument, then statistical analysis was performed. Results The postoperative levels of EMP, ICAM-1 and ET-1 of control group were (693.46±90.72), (768.58±20.46)μg/L and (31.27±8.18)ng/L, which were significantly higher than those in the observation group [(652.36±67.39), (752.37±25.0)μg/L, (28.22±5.05)ng/L], the differences were statistically significant (t=2.41, 2.67, 2.68, all P<0.05). After operation, the hs-CRP, TNF-α, IL-6 levels in the control group were (4.16±2.35)mg/L, (4.32±2.02)ng/L, (10.59±3.16)ng/mL, which were significantly higher than those in the observation group [(2.22±1.47)mg/L, (2.74±1.52)ng/L, (6.33±2.24)ng/mL], the differences were statistically significant(t=2.65, 2.67, 3.42, all P<0.05). The postoperative TT, PT, APTT in the observation group were (26.31±3.18)s, (14.34±1.67)s, (27.20±4.12)s, which were significantly longer than those in the control group [(24.03±2.84)s, (12.56±1.43)s, (24.55±3.62)s], the differences were statistically significant(t=2.15, 2.31, 2.65, all P<0.05). Conclusion Tirofiban combined with reteplase can improve endothelial function, inhibit inflammatory reaction and regulate coagulation function. Key words: Myocardial infarction; Platelet membrane glycoprotein IIb; Tirofiban hydrochloride; Reteplase

Effect of different anti-platelet therapies on QT dispersion in patients with acute coronary syndrome after percutaneous coronary intervention

Objective To investigate the effect of anti-platelet therapy on QT dispersion(Qtd, QTcd) in patients with acute coronary syndrome(ACS) after percutaneous coronary intervention(PCI). Methods 80 patients with ACS and undergoing PCI were divided into the control group and the observation group by the random number table method, 40 cases in each group.The control group was treated with routine antiplatelet therapy, oral administration of aspirin and clopidogrel, while the observation group was treated with intensive antiplatelet therapy and tirofiban based on the treatment in the control group.The changes of platelet aggregation function and inflammation indices before and after treatment were compared between the two groups.The changes of QT dispersion in the two groups were monitored by electrocardiogram.Both two groups were followed up for 1 year, and the incidence rate of adverse events was analyzed statistically. Results Before treatment, there were no significant differences in platelet aggregation indices (MPAR, PRU), levels of inflammatory factors (hs-CRP, sCD40L) and QT dispersion between the two groups (all P>0.05). After treatment, MPAR and PRU in the observation group were lower than those in the control group[(30.26±8.42)%, (114.36±10.26)U vs.(39.33±9.4)%, (143.86±12.65)U](t=4.542, 11.454, all P<0.05), the levels of hs-CRP and sCD40L were lower than those in the control group[(2.12±0.62 )mg/L, (1.71±0.94)μg/L vs.(2.94±0.44)mg/L, (2.76±1.23)μg/L](t=6.748, 4.289, all P<0.05), and QTd and QTcd were also lower than those in the control group[(25.41±3.32)ms, (26.12±4.26)ms vs.(29.52±2.98)ms, (30.51±3.97)ms](t=5.826, 4.768, all P<0.05). During the follow-up, the incidence rate of restenosis or thrombosis in stent of the observation group was lower than that of the control group (2.50% vs.15.00%) (χ2=3.913, P<0.05). Conclusion The application of tirofiban anti-platelet therapy in patients with ACS after PCI can reduce the inflammatory responses, reduce platelet aggregation rate, shorten QT dispersion and reduce the incidence of adverse events. Key words: Acute coronary syndrome; Percutaneous coronary intervention; Tirofiban; QT dispersion

Validated spectrofluorimetric methods for the determination of apixaban and tirofiban hydrochloride in pharmaceutical formulations

Apixaban and Tirofiban Hydrochloride are low molecular weight anticoagulants. The two drugs exhibit native fluorescence that allow the development of simple and valid spectrofluorimetric methods for the determination of Apixaban at λ ex/λ em=284/450nm and tirofiban HCl at λ ex/λ em=227/300nm in aqueous media. Different experimental parameters affecting fluorescence intensities were carefully studied and optimized. The fluorescence intensity-concentration plots were linear over the ranges of 0.2–6μgml−1 for apixaban and 0.2–5μgml−1 for tirofiban HCl. The limits of detection were 0.017 and 0.019μgml−1 and quantification limits were 0.057 and 0.066μgml−1 for apixaban and tirofiban HCl, respectively. The fluorescence quantum yield of apixaban and tirofiban were calculated with values of 0.43 and 0.49. Method validation was evaluated for linearity, specificity, accuracy, precision and robustness as per ICH guidelines. The proposed spectrofluorimetric methods were successfully applied for the determination of apixaban in Eliquis tablets and tirofiban HCl in Aggrastat intravenous infusion. Tolerance ratio was tested to study the effect of foreign interferences from dosage forms excipients. Using Student's t and F tests, revealed no statistically difference between the developed spectrofluorimetric methods and the comparison methods regarding the accuracy and precision, so can be contributed to the analysis of apixaban and tirofiban HCl in QC laboratories as an alternative method.

Effect and safety of tirofiban in PCI patients with non-ST elevation acute coronary syndrome

Objective To investigate the effect and safety of tirofiban in PCI patients with non-ST elevation acute coronary syndrome(NSTE-ACS). Methods 80 high-risk patients were randomly divided into treatment group(tirofiban+ PCI) and control group(PCI). Collected all the clinical and coronary angiography.The coronary reperfusion flow(TIMI grade) of the culprit vessel after PCI, ultrasound cardiogram 1 week after PCI, bleed events, major adverse cardiac events with 30 days and one year, and heart function status were compared between the two groups. Results TIMI after PCI, major adverse cardiac events within 30 days, heart function status after one year, revascularization within 1 year in the treatment group were superior to the control group(χ2=42, 3, 2, 28, all P<0.05). Conclusion Tirofiban is safe and effective for elderly patients with NSTE-ACS received PCI. Key words: Myocardial infarction; Tirofiban; Interventional therapy

Application effect of ACT monitor cooperated with special nursing during PCI perioperation

Objective To monitor the evaluation of heparin dose in activated clotting time (ACT) during PCI perioperation, and explore its application in clinical care. Methods Totally 327 patients with coronary angiography, PTCA and stent implantation, using heparin to anticoagulating simultaneously in conduit room of the 306th Hospital of PLA from April 2014 to April 2015. By ACT monitoring and preoperative nursing visit, we collected patients′ risk factors, and made operation plans; patients were assigned to five groups by the stage of age, and ten year-old was taken as a stage. ACT was closely observed in the operation, and the risk situation of patients was also observed; after operation, specific guidance was taken. Results There were patients with substandard ACT in each group after operation, and needed additional heparin. 71 cases of patients with preoperative application of tirofiban, their postoperative ACT were within the target range 200-250 s; among 256 patients without preoperative application of tirofiban, there were 41 patients whose ACT value does not reach the required target value and needed additional heparin, wherein the incidence rate of substandard VCT value of 55-64 year-old group was the highest and was 20%. Eight cases without preoperative application of tirofiban, had sheath pipe pulled out because of errhysis in femoral artery sheath pipe puncture after operation, but their VCT value was within the target range of target value. All patients had no intraoperative and postoperative stroke, bleeding and thrombosis, etc. Conclusions ACT monitoring and effective coordination of care, can ensure the safety of heparin used in interventional procedures. Key words: Heparin; Whole blood coagulation time; Nursing; Percutaneous coronary intervention

Development of alternative HPLC method for determination of tirofiban in rat serum

&lt;p&gt;Tirofiban hydrochloride is a reversible antagonist of fibrinogen binding to the GPIIb/IIIa receptor, used for the treatment of acute coronary syndrome. A novel RP-HPLC method has been developed and validated for the determination of Tirofiban in serum of Wistar rats with and without deep acute venous thrombosis. The chromatographic separation was carried out using a reverse-phase HPLC column Purospher® RP-18e (150 mm ´ 4.6 mm i.d.; 5 μm) coupled with a guard column LiChrosorb® (4 mm ´ 4 mm i.d.; 7 μm) and mobile phase consisting of the mixture of 1-octane sulfonic acid in water (pH 3.0, adjusted with orthophosphoric acid) and acetonitrile, with a ratio of 60 : 40 (&lt;em&gt;v/v&lt;/em&gt;) and a flow rate of 1.0 ml/min, at a wavelength of 277 nm. The serum concentrations of Tirofiban in the group of rats with DVT were lower than those in the control group, and it could be explained with the binding of Tirofiban with the GPIIb/IIIa receptors. &lt;/p&gt;

Comparison of the perioperative complications among three prophylactic antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling

Objective To compare the perioperative complications of prophylactic use of three antiplatelet strategies in unruptured intracranial aneurysms treated by stent assisted coiling. Methods A total of 203 consecutive patients were brought into this retrospective study including the following three groups: the loading group (n=54), with a loading dose of 300 mg to 600 mg clopidogrel at 2 h to 24h before the stenting; tirofiban group (n=50), a loading dosage of tirofiban (8 μg/kg/min over 3 min) followed by a 0.1μg/kg/min maintenance dosage; dual antiplatelet group (n=99), dual oral antiplatelet drugs (clopidogrel 75 mg+ aspirin 100 mg) pretreated for 3-5 days before the operation. Events of hemorrhage and thromboembolism were recorded and the complications were compared to assess the safety and efficacy of various antiplatelet strategies. Chi-square or Fisher exact tests were used for categorical variables. Results The hemorrhagic rates were 11.1% in loading group, 2.0% in dual antiplatelet group, and 0% in tirofiban group, respectively, while the thromboembolic rates were 7.4% in loading group, 4.0% in dual antiplatelet group, and 0% in tirofiban group, respectively. For total complications, significant difference (P 0.05). The hemorrhagic rate in loading group was significantly higher than that of the dual group (P=0.023) and tirofiban group (P=0.027), while there was no significant difference between tirofiban group and dual antiplatelet group (P>0.05). In subgroup analysis of the loading group, the postoperative thromboembolic rate was significantly higher in those exposed to low molecular weight heparin than those not (P=0.039) with no increase of hemorrhagic events (P>0.05). Conclusions When compared with the dual antiplatelet strategy, tirofiban strategy may be used as a new prophylactic protocol in unruptured intracranial aneurysms treated by stent assisted coiling. Those treated by low molecular weight heparin postoperatively after receiving dual antiplatelet therapy may increase the hemorrhagic risk, although there was a significant decrease in thromboembolic events postoperatively. Key words: Intracranial aneurysm; Thromboembolism; Platelet aggregation inhibitors; Stents

Effects of intracoronary administration of tirofiban in the patients with acute myocardial infarction that had no reflow phenomenon of infarct related artery(IRA)after primary percutaneous transluminal coronary intervention

Effects of intracoronary administration of tirofiban in the patients with acute myocardial infarction that had no reflow phenomenon of infarct related artery(IRA)after primary percutaneous transluminal coronary intervention

Effect of intracoronary tirofiban bolus administration on platelet-derived microparticles and short-term clinical benefit in patients with acute ST-segment elevation myocardial infarction

Objective To investigate the effect of intracoronary tirofiban bolus administration on platelet-derived microparticles (PMPs) and its correlation with the short-term clinical benefit in patients with acute ST-segment elevation myocardial infarction (ASTEMI) undergoing emergency percutaneous coronary intervention (PCI). Methods A total of 90 patients with ASTEMI undergoing emergency PCI were selected and randomized into the intracoronary group (intracoronary tirofiban 10.00 μg/kg bolus within 1-3 min followed by intravenous continuous infusion at 0.15 μg·kg-1·min-1 for 36 h, n=30), intravenous group (intravenous tirofiban 10.00 μg/kg bolus within 1-3 min followed by intravenous continuous infusion at 0.15 μg·kg-1·min-1 for 36 h, n=30) and control group (without tirofiban administration, n=30). The 3 ml blood samples from coronary artery were obtained before and 10 min after tirofiban infusion. The 3 ml blood samples from radial artery were collected 24 hours after tirofiban infusion and 12 hours after drug withdrawal. The counts of PMPs were analyzed by flow cytometry. The thrombolysis in myocardial infarction (TIMI) flow grade classification and TIMI Myocardial Perfusion Grade in the culprit blood vessel after PCI, and the incidences of bleeding and major adverse cardiac events (MACE) within 30 days after surgery were recorded. Results There was no significant difference in baseline of PMPs among intracoronary group, intravenous group and control group (all P>0.05). The level of PMPs was decreased in the intracoronary and intravenous group as compared with the control group 〔(3.6±2.3)%, (5.1±2.7)% vs. (6.7±3.2)%, P 0.05), and PMPs levels were lower in intracoronary and intravenous group than in control group (both P 0.05). Immediately after PCI, the TIMI flow grade and TIMI myocardial perfusion grade in the culprit blood vessel in intracoronary group were superior to those in the intravenous group and control group (P 0.05). Conclusions The intracoronary versus intravenous tirofiban administration can effectively and immediately reduce the number of PMPs in patients with acute ST-segment elevation myocardial infarction undergoing emergency interventional treatment, quickly inhibit the activated platelets, and decrease the total major adverse cardiovascular events without increasing the risk of bleeding. Key words: Myocardial infarction; Blood platelets; Angioplasty, intervention, percutaneous coronary

Application of Lvis stents in endovascular treatment of intracranial wide-necked aneurysms

Objective To investigate the safety and efficacy of Lvis stent-assisted embolization of intracranial wide-necked aneurysms. Methods Twenty-four patients with intracranial wide-neck aneurysm treated with Lvis stent-assisted embolization at the Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University from January to July 2014 were selected. The clinical data, endovascular treatment methods and efficacy of the 24 patients were analyzed retrospectively. The degree of aneurysm embolization was evaluated according to Raymond classification, and its clinical efficacy was evaluated according to the modified Ranking scale (mRS) scores. Results The stents of 24 patients with intracranial wide-necked aneurysms were released completely (100%). Raymond grade Ⅰ embolization was 18 cases (75%), Raymond grade Ⅱ embolization was 4 cases (17%), and Raymond grade Ⅲ embolization was 2 cases (8%). One patient had in-stent thrombosis in the process of embolization, and after being treated with tirofiban hydrochloride sodium chloride injection, the thrombosis disappeared. The effective rate of embolization was 92%. After six months of follow-up, 21 patients had good curative effect (the mRS score 0-2), 3 had poor effect (the mRS score 3-6), and the good rate was 88%. Conclusion Lvis stent-assisted embolization of intracranial wide-neck aneurysms is safe and feasible, the short-term efficacy is reliable. Because of the short follow-up time, further research is needed to determine the long-term stability of coils and adaptability of stents after embolization. Key words: Intracranial aneurysm; Stents; Endovascular treatment; Treatment outcome

Effect of UK combined with tirofiban in young patients with ST segement elevation acute myocardial infarction

Objective To study the thrombolysis effect and safety of UK combined with tirofiban in young patients with ST segement elevation acute myocardial infarction. Methods 76 young patients with ST segement elvation acute myocardial infarction were selected as research objects,and they were divided into UK group(control group,n= 34)and UK combined with tirofiban group(observation group,n=42)by random number table,then the recanalization rate of infarct-related artery and incidence of complications were compared. Results The recanalization rate of infarct-related artery in the observation group was 97.6%,which was 91.2%in the control group,there was no significant difference between the two groups(χ2=1.564,P>0.05);The vascular infarction related to blood flowⅡlevel of the patients was 90.5%in the observation group,which was significantly higher than 70.6%in the control group (χ2=4.945,P 0.05). Conclusion The thrombolysis effect of UK has a high recanalization rate of infarct-related artery in young patients with ST segement elevation acute myocardial infarction,and the thrombolysis effect of UK combined with tirofiban is better,and it does not increase the incidence of complications. Key words: Myocardial Infarction; Thrombolytic Therapy; Tirofiban; Urokinase

Regulatory role of the platelet membrane glycoprotein CD61 and CD62P in septic inflammation

Objective To observe the regulation of platelet membrane glycoprotein CD61,CD62P in septic inflammation. Methods Make the model of sepsis by cecal ligation and puncture(CLP). Sixty male BALB/c mice were randomly divided into 4 groups(negative control,sham operation,CLP,CLP+ Tirofiban). The platelet counts, expressions of CD61 and CD62P in peripheral platelets, levels of tumor necrosis factor-α(TNF-α) and interleukin(IL)-6 in serum were measured at 24 h after operation. Results Compared with those of negative control group[(289.7±45.9)×106/L], sham operation group[(267.7 ±25.4)×106/L]and CLP+ Tirofiban group[(217.0±29.7)×106/L], the platelet count was lower in mice with CLP[(167.0±31.4)×106/L, P< 0.01]. The expressions of CD61[(91.22±2.96)%], CD62P[(7.87±2.90)%], TNF-α[(723.51±96.65) ng/L] and IL-6[(757.35±131.48) ng/L] in mice with CLP increased significantly(P< 0.01). However, the expressions of CD61[(67.50± 8.67)%], CD62P[(3.53±0.78)%], TNF-α[(426.38±16.69) ng/L]and IL-6[(482.32±56.73) ng/L]in mice with CLP+ Tirofiban were all lower than that of CLP group(P< 0.01).There is positive correlation between the expression of platelet membrane glycoprotein and the expression of inflammatory factors in mice with CLP. Conclusion Platelet activation is closely related to the inflammatory response of sepsis. Down-regulation of platelet membrane glycoprotein can significantly attenuate the septic inflammation. Key words: Sepsis; Platelet membrane glycoprotein; CD61; CD62; Inflammatory reaction

PP-004 Tirofiban Induced Anemia without Thyrombocytopenia

PP-004 Tirofiban Induced Anemia without Thyrombocytopenia

Efficacy and safety evaluation of half quantity of tirofiban on elderly patients with ST segment elevation myo-cardial infarction

Objective To investigate clinical efficacy and safety of half quantity of tirofiban on elderly patients with ST segment elevation myocardial infarction （STEMI）.Methods 120 elderly patients with STEMI underwent emergency PCI patients,120 cases of digital method were randomly divided into the control group and observation group,60 cases in the control group with conventional surgery and drug treatment,the observation group of 60 cases on the basis of conventional therapy was given to half the amount for tirofiban,the two groups were observed in the risk of bleeding, the occurrence of adverse cardiovascular events after operation.Results The postoperative bleeding risk of the observation group compared with the control group had no significant difference（χ^2 =1.51,1.35, 0.94,P=0.643,0.768,0.578）;for the observation group in 30 days after operation,90 days of re infarction,death and target vessel revascularization rate compared with the control group decreased,the difference was statisticallysig-nificant（30 days after operation,χ^2 =9.54,18.33,16.75,P=0.043,0.029,0.031;90 days after operation,χ^2 =17.48,21.78,19.54,P=0.034,0.011,0.021）.Conclusion Semi quantity for tirofiban can reduce the risk of elderly patients with STEMI after PCI,improve clinical outcome,which will not increase the risk of hemorrhage. Key words: Tirofiban; Myocardial Infarction; Angioplasty,transluminal,percutaneous coronary; Aged

Tirofiban induced anemia without thrombocytopenia

Tirofiban induced anemia without thrombocytopenia

Related factors analysis of peripheral vascular complications after percutaneous coronary intervention in elderly patients with coronary heart disease

Objective To understand the situation of the incidence of peripheral vascular complications after pereutaneous coronary intervention （PCI） in elderly patients with coronary heart disease, and to explore its related factors. Methods One hundred and three elderly patients with coronary heart disease after PCI were chosen according to the convenient sampling through the cross-sectional study, and were surveyed by the self- designed demographic tables and disease-related tables, and the data were collected and analyzed. Results The incidence of peripheral vascular complications was 21.4% in the elderly patients with coronary heart disease after PCI, and the incidence of local oozing bleeding was the most （ 13.6% ）, followed by 4.9% of the hematoma, 2. 9% of subcutaneous ecchymosis around puncture point, 2. 9% of forearm swelling. The occurrence of peripheral vascular complications was different in the patients with different age, marital status, combined with hyperlipidemia, puncture site, surgical time, duration of surgery, number of diseased vessels, the use of heparin during operation, postoperative use of Tirofiban and Plavix, and the differences were statistically significant （P 〈 0. 05）. Logistic regression analysis showed that the related factors of peripheral vascular complications after PCI included the marital status, puncture site, number of diseased vessels, intraoperative use of heparin, postoperative use of Tirofiban and Plavix. Conclusions The patients with older, non-marriage, emergency surgery, long time of surgery, puncture through the femoral artery, many diseased vessels, severe anterior descending artery stenosis, intraoperative use of large heparin, postoperative use of Tirofiban and Plavix are more susceptible to peripheral vascular complications, which suggests that we should put these patients as the focus of nursing in the future work. Key words: Elderly; Coronary heart disease; Percutaneous coronary intervention; Peripheral vascular complication; Related factors

Effect and safety of tirofiban in the treatment of acute coronary syndromes

Objective To analyze the clinical efficacy and safety of tirofiban in the treatment of acute coronary syndrom.Methods 80 cases with acute coronary syndrome , were randomly divided into the observation group and control group ,two groups were given aspirin ,grey,low molecular weight heparin treatment ,the observation group was given based on the class for tirofiban intravenous injection , the control group was given a placebo , the clinical effect were compared between two groups .Results In the observation group ,30 d end point event rate of 15.00%,significantly lower than that of the control group 30.00%（χ2 =4.56,P〈0.05）;The observation group was administered 3 d after the electrocardiogram showed the degree of ST-T segment depression in lead and ischemia were （0.30 ±0.43）mm,（2.1 ±2.5）,was significantly better than that of the control group （0.67 ±0.73） mm,（3.4 ± 2.5）（t =5.12,3.56,all P 〈0.05）.Conclusion Aspirin,clopidogrel,heparin combined voith tirofiban can effectively improve the clinical symptoms of patients with myocardial ischemia , and can reduce the incidence of adverse events,which is worthy of clinical application . Key words: Tirofiban; Coronary artery disease; Treatment Outcome

Effect of comprehensive nursing intervention on clinical efficacy of the combination of PCI and tirofiban in patients with acute STEMI

Objective To investigate and discuss the clinical efficacy and nursing experience of the combination of tirofiban and percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI).Methods A total of 80 patients with acute STEMI who had undergone the combination of PCI and tirofiban in our hospital were selected and randomly divided into the control group (routine nursing) and the observation group (comprehensive nursing intervention),with 40 patients in each group.The blood flow perfusion thrombolysis in myocardial infarction trial (TIMI)classification,the resolution of ST-segment,and complications in the two groups were observed and compared.Results The effect rate of blood perfusion in the observation group was significantly higher that in the control group (95.0％ vs 65.0％),and the difference was statistically significant (x2 =11.25,P ＜ 0.05).The resolution rate of ST segment obviously increased in the observation group compared with the control group (85.0％ vs 65.0％),and the difference was statistically significant (x2 =4.27,P ＜ 0.05).The incidence of complications was significantly decreased in the observation group compared with the control group (7.5％ vs 25.0％),with statistical difference between the two groups (x2 =4.50,P ＜ 0.05).Conclusions For patients with acute STEMI who had undergone the combination of PCI,the effective application of comprehensive nursing intervention in the perioperative period can significantly improve the clinical efficacy and reduce the incidence of complications,which should be worthy of clinical promotion. Key words: Percutaneous coronary intervention; Nursing; Tirofiban; Myocardial infarction