Effects And Safety Of Tirofiban In Old Patients With Acute Coronary Syndrome And Complicated Diabetes On The Basis Of PCI Treatment

The pathogenesis of ACS is due to unstable coronary atherosclerosis plaquewhich rupture leading to thrombosis. Platelet aggregation is coagulation systemactivated in blood and the premise of thrombosis, so the antiplatelet therapy isthe first treatment of ACS. Tirofiban can inhibit platelet aggregation mediatedby fibrous protein and block the final common pathway of Platelet aggregation.So, Tirofiban is with a strong anti platelet aggregation, which can reduce PCIrelated coronary events significantly. DM is the independent risk factors ofacute coronary events. DM patients with high blood pressure, blood lipidmetabolic disorders, obesity and inhibition of fibrinolytic activity in blood andother factors, the above factors may trigger a PCI intraoperative coronaryinflammation process which lead to the outbreak of thrombotic events. SoDM with ACS needs to strengthen the antiplatelet therapy. The patients withACS often use multiple antiplatelet therapy after PCI, however, the increase inthe risk of hemorrhage by excessive antithrombotic therapy is come into moreand more notice. Clinical practice is observed that the use of Tirofiban isaccompanied by the high risk of bleeding, especially for older patients.Sometimes directly resulted in the death in patients with severe bleedingcomplications. Strengthen antithrombotic therapy reduced the incidence of ischemic events, but the subsequent risk of bleeding often a big problem worthour concern. So for elderly patients with ACS combined with DM and PCIsurgery.There is the double risk of thromboembolism and bleedingcomplications, the choice of reasonable antithrombotic treatment is particularlyimportant.The purpose of this paper is to discuss the validity and security of usingdifferent doses of Tirofiban in PCI therapy for the aged patients with diabetesmellitus.Objective: To evaluate the curative effects and safety of early tirofibanhydrochloride application on the ba-sis of aspirin，clopidogrel，low molecularweight heparin (LMWH) treatment and PCI in old patients with acute coronarysyndrome com-plicated with diabetes．Methods: A total of126cases of hospitalized patients with acute coronarysyndrome accompanied by diabetes were randomly divided into the lowmolecular weight heparin (LMWH) treatment group-control group(40cases),the whole-tirofiban group-experimental groupⅠ(44cases), and thehalf-tirofiban group-experimental groupⅡ(42cases).Results: Incidence rates of all-cause death and refractory angina pectorisin the hospital and the half of year were lower in the experimentalgroupⅠandⅡthan in the control group (P＜0.05)，while rates of Mace werenot statistically different between the experimental groupⅠandⅡ (P＞0.05).No case of severe-hemorrage was observed for three groups; numbers of non-hemorrhage， mild-hemorrage， and moderate-hemorrage cases hadsignificant differences between the groups. experimental groupⅡwere higherthan in the control group and the experimental groupⅠ（P＜0.05)，while ratesof hemorrage cases were not statistically different between the control groupand the experimental groupⅠ(P＞0.05).The platelet count was not significantlydifferent in the three group (P＞0.05)．Conclusion: It is both effective and safe of half-tirofiban hydrochloride totreat patients with acute coronary syndrome and complicated diabetes on thebasis of PCI treatment．...