The Short-term Outcome Of Tirofiban In The Treatment Of Acute Coronary Syndromes With PCI

Objection—We sought to examine if tirofian treatment in coronary drug elution stenting improved clinical outcomes among ACS patients without high risk of bleeding .The aim of the study was also to assess whether there are age-dependent differences in the clinical benefit of tirofiban.Methods—The study was an open-label randomized and controlled cohort trial. A total of 100 ACS patients undergoing PCI were pretreated with aspirin,clopidogrel and low molecular weight heparin .48 patients were given the administration of tirofiban in the catheterization laboratory besides heparin, compared with a matched control group of 52 patients treated with heparin alone. The incidence of major adverse cardiac events (new myocardial infarction/death/target vessel revasculation) during the residential period after PCI and the incidence of angina in residential and three months were assessed. On the basis of cutoff age , patients were analysed separatedly.Results—Frequencies of angina reduced more in tirofiban group than in control(p=0.039 in residential;p=0.044 in three months). In contrast, no benefit was observed among older patients(p=0.456 in residential;p= 1.000 in three months).There was no difference in major adverse cardiac events between the tirofiban and the control group. High risk of Bleeding occurred in older patients(p=0.042).In all patients enrolled in the tirofiban group, there appeared to be a reduction of death(P=0.026) or refractory ischemia(p=0.007) among young patients compared with the older.Conclusions—In patients with ACS undergoing PCI, the efficacy of tirofiban appears, but age-dependent. The older ones have more risk of bleeding.