Open AccessEfficacy and Safety of Standard‐Dose Versus Half‐Dose Tirofiban in Patients with Non‐ ST Elevation Acute Coronary Syndromes Undergoing Early Percutaneous Coronary Intervention
Author(s) -
Li Wei,
Fu Xianghua,
Xue Haiwei,
Wang Yanbo,
Wang Xuechao,
Zhao Yujun,
Geng Wei,
Yang Zengxin,
Gu Xinshun,
Hao Guozhen,
Jiang Yunfa,
Fan Weize,
Wu Weili,
Li Shiqiang
Publication year - 2013
Publication title -
cardiovascular therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.818
H-Index - 46
eISSN - 1755-5922
pISSN - 1755-5914
DOI - 10.1111/1755-5922.12004
Subject(s) - tirofiban , medicine , timi , conventional pci , percutaneous coronary intervention , bolus (digestion) , cardiology , acute coronary syndrome , mace , perfusion , anesthesia , myocardial infarction
Summary Introduction To explore the optimal dosage of tirofiban associated with double benefits of efficacy and safety in patients with non‐ ST elevation acute coronary syndromes ( NSTE ‐ ACS ) undergoing early percutaneous coronary intervention ( PCI ). Aims A total of 163 patients were included in this study (78 in SD group versus 85 in HD group). In SD ( HD ) group, tirofiban was administered intravenously with a bolus dose of 10 (5) μg/kg within 3 min and followed by continuous intravenous infusion of 0.15 (0.075) μg/kg/min for 48 h. Within 24 h on admission, patients underwent CAG or CAG + PCI . The angiographic results (initial TIMI , final TIMI / CTFC / TMPG ) were evaluated. Platelet aggregation rate ( PAR ) was measured before and 2, 24, 48 h after bolus tirofiban. MACE s were evaluated at 7‐day, 30‐day, and 6‐month follow‐up. Bleeding was observed at 7 days. Results The proportions of TIMI grade 3 seemed higher in SD group before and after PCI followed by a better myocardial perfusion, but not statistically different ( P = 0.26/0.08). PAR was lower in SD group than that in HD group at 2 h after bolus tirofiban ( P = 0.03). MACE s were not statistically different at 7, 30 day, and 6 month in two groups. The incidence of minor bleeding was significantly lower in HD group than that in SD group (8.2% vs. 20.5%, P = 0.04). The risk of bleeding would increase under the conditions of decreased PAR , increased dose of tirofiban and decreased CC r. Conclusion Half‐dose tirofiban was not inferior to standard‐dose in efficacy, what is more, half‐dose tirofiban showed a better safety characteristic of lower bleeding risk. Therefore, half‐dose tirofiban is recommended to patients with NSTE ‐ ACS undergoing early PCI .