Therapeutic effect analysis of tirofiban treatment on acute coronary syndrome in elderly patients
10.3760/cma.j.issn.0254-9026.2010.11.016
- VernacularTitle:替罗非班治疗老年人急性冠状动脉综合征的疗效分析
- Author:
Hui WANG
;
Mei SONG
;
Zhaoyang XUE
;
Zhijian YANG
;
Tiebing ZHU
;
Liansheng WANG
;
Min LU
;
Ning ZHANG
;
Wei LI
;
Kejiang CAO
- Publication Type:Journal Article
- Keywords:
Angina,unstable;
Myocardial infarction;
Myocardial reperfusion
- From:
Chinese Journal of Geriatrics
2010;29(11):927-931
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the curative effect of tirofiban treatment on high-risk acute coronary syndromes (ACS) in elderly patients receiving an early percutaneous coronary intervention (PCI) treatment. Methods The 162 elderly cases including unstable angina pectoris and non-ST -segment elevation myocardial infarction (NSTEMI) undergoing early PCI were enrolled in this study.And they were assigned to early treatment group (n=82) and deferred selective group (n=80)according to the time of using tirofiban (Gp Ⅱ b/Ⅲ a inhibitor) treatment. The effectiveness of either strategic option on tissue-level perfusion was evaluated using the TIMI myocardial perfusion grade (TMPG) before and immediately after PCI. The corrected TIMI frame count (cTFC) was also used to assess coronary artery flow and myocardial perfusion. Bleeding complications and the composite end point events at 30 days were also evaluated. Results Of all the 162 patients, the TMPG 0-1 perfusion was observed in 65 patients (40.1%). The TMPG 0-1 perfusion was significantly less frequent in early treatment group (32.9%) than in deferred selective group (47.5%) before PCI (x2=3.58, P＜0.05); while the results of TIMI grade 0-1 flow (26.8% vs. 25.0%) and cTFC levels (34.2±11.8 vs. 34. 9±12. 7) before PCI were similar between the two groups (x2 =0. 07, P=0.47; t= 0.13, P=0.71, respectively). No differences were seen both in composite end point events at 30 days and bleeding complications (x2 = 0.31, P＞0.05; x2=0.004, P＞0. 05). Conclusions High -risk ACS patients treated with an early invasive strategy, routine upstream use of tirofiban are associated with improved tissue-level perfusion before PCI and does not increase bleeding complications when bleeding risks are carefully evaluated before enrollment.
