The clinical effect of tirofiban with low molecular weight heparin in patients with acute non-ST segment elevation myocardial infarction.
- Author:
Sang Yup LIM
1
;
Eun Hui BAE
;
Myung Ho JEONG
;
Sang Hyun LEE
;
Han Gyun KIM
;
Ji Hyun LIM
;
Hyung Wook PARK
;
Young Joon HONG
;
Ok Young PARK
;
Ju Han KIM
;
Weon KIM
;
Young Keun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
Platelets;
Angioplasty;
Prognosis
- MeSH:
Acute Coronary Syndrome;
Angioplasty;
Blood Platelets;
Death;
Follow-Up Studies;
Glycoproteins;
Hemorrhage;
Heparin, Low-Molecular-Weight*;
Humans;
Jeollanam-do;
Myocardial Infarction*;
Percutaneous Coronary Intervention;
Platelet Activation;
Prognosis;
Prospective Studies;
Risk Factors;
Thrombosis
- From:Korean Journal of Medicine
2003;65(5):527-534
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUN: Platelet activation and aggregation with resultant arterial thrombus formation play pivotal roles in the pathophysiology of acute coronary syndrome. We prospectively evaluated the long-term clinical effect of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, with low molecular weight heparin (LMWH) in the treatment of non-ST segment elevation myocardial infarction (NSTEMI). METHODS: We divided consecutive 90 patients with NSTEMI who underwent percutaneous coronary intervention (PCI) between August 2001 and April 2002 at Chonnam National University Hospital into 2 groups: Group I (n=45: LMWH alone, 62.3 +/- 9.8 years, 32 male) and II (n=45: tirofiban with LMWH, 59.2 +/- 10.2 years, 36 male). Major adverse cardiac events (MACE) were analyzed between two groups at 7 days after admission, and during 3-month and 6-month clinical follow-up. RESULTS: Mean age, sex and risk factors were not different between two groups. Minor bleeding developed in 1 patient (2.2%) of each group (p=NS). Cardiac death occurred in 4 (8.9%) of group I and 3 patients (6.7%) of group II, and revascularization was required in one patient (2.2%) of each group until 7 days after admission (p=NS). During 3-month follow-up period, revascularization was required in 7 (15.6%) of group I and 5 patients (11.1%) of group II (p=NS). MACE during 6-month follow-up occurred in 11 patients (24.4%) of group I and 4 patients (8.9%) of group II (p=0.012): revascularization was required in 4 (8.9%), myocardial infarction occurred in 2 (4.4%), and cardiac death in 5 patients (11.1%) of group I, and revascularization in 1 (2.2%) and cardiac death in 3 patients (6.7%) of group II. CONCLUSION: Tirofiban with LMWH is safe without significant bleeding complications and improve long-term prognosis in patients with NSTEMI underwent PCI.
