Safety and efficacy of short-term perioperative tirofiban in elderly patients with acute STEMI undergoing primary PCI
10.3969/j.issn.1009-0126.2024.08.004
- VernacularTitle:短时程替罗非班在高血栓负荷的老年急性心肌梗死患者围术期应用的安全性及疗效观察
- Author:
Le AN
1
;
Xi KANG
;
Li WANG
;
Hui ZHANG
;
Yanzhao REN
;
Xue TIAN
;
Fang TIAN
;
Ling ZHANG
;
Chunxing SUI
Author Information
1. 116033 大连理工大学附属大连市中心医院冠心病三科
- Keywords:
myocardial infarction;
tirofiban;
percutaneous coronary intervention;
short duration
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(8):871-875
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the safety and efficacy of perioperative short-duration platelet membrane glycoprotein Ⅱ b/Ⅲ a receptor antagonist(GPI)in elderly patients undergoing primary percutaneous coronary intervention(PPCI)for acute ST-segment elevation myocardial infarction(STEMI)with high thrombotic burden.Methods A total of 140 elderly patients with acute STEMI admitted to our department from October 2021 to January 2024 were recruited and ran-domly divided into experimental group(short duration)and control group(standard duration),with 70 cases in each group.The occurrence of MACE,complete rate of ST segment resolution 2 h after surgery,blood flow classification thrombolysis in myocardial infarction(TIMI),left ventric-ular ejection fraction(LVEF),N-terminal pro-B-type natriuretic peptide(NT-proBNP),inhibition of platelet aggregation(IPA)by thromboelastography(TEG),maximum amplitude of adenosine diphosphate receptor pathway(MAADP),platelet-related indicators,and incidences of thrombocy-topenia and bleeding events were observed in the 2 groups after operation.Results There were no significant differences in postoperative recurrence of angina pectoris,acute heart failure,malignant arrhythmia,rate of ST segment resolution,TIMI blood flow grade 3,no reflow,LVEF,NT-proBNP level before discharge,and incidences of severe hemorrhage and thrombocytopenia during hospi-talization between the two groups(P＞0.05).The experimental group had significantly lower IPA[(76.1±15.3)％vs(96.3+19.4)％,P=0.016]and higher MAADP(45.6±8.2 mm vs 26.7±9.7 mm,P=0.028)in 18 h after operation,and lower incidence of minor bleeding(7.1％vs 24.3％,P＜0.05)during hospitalization when compared with the control group.Conclusion Under the premise of using a novel oral purinergic receptor P2Y12 inhibitor,short-term GPI is not inferior to the standard time course in achievement of IPA,with similar efficacy and relatively better safety.
