Effect Of Low-dose Tirofiban On30-day Prognosis After Implantation Of Long Drug-eluting Stent

Objective:To evaluate the effect of low-dose tirofiban on30-day prognosis after implantation of long (single stent length:≥30mm) drug-eluting stent (DES).Methods:we conducted a retrospective analysis of575patients undergoing long DES implantation at our hospital from January2005through December2010, and the patients were treated with either low-dose tirofiban plus aspirin and clopidorel (TAT group, n=385) or aspirin and clopidorel (DAT group, n=190). Tirofiban was administered intravenously with a lodaing dose of4-5ug/kg for3minutes and a maintaining dose of0.05-0.075ug/(kg·min) for36to48hours, or maintaining dosage only. The incidence of major adverse cardiac events (MACE), stent thrombosis (ST), bleeding and thrombocytopenia were compared at30days. MACE were defined as acute myocardial infarction (AMI), urgent target vessel revascularization (UTVR) or death.Results:During30-day follow-up period, MACE occurred in2(0.52%) patients in the TAT group, compared with8(4.22%) in the DAT group (p=0.003).2(0.52%) patients developed AMI in the TAT group and8(3.68%) in the DAT group (p=0.007).2(0.52%) patients undergone UTVR in the TAT group and8(3.68%) in the DAT group (p=0.007). No death was record in the TAT group but1(0.53%) in the DAT group (p=0.330).1(0.26%) patient in the TAT group experienced ST, as compared to6(3.16%) in the DAT group (p=0.006). Kaplan-Meier survival curves showed that the incidence of MACE in the TAT group was lower than the DAT group (p=0.001). Bleeding was present in1(0.78%) patient in TAT group compared with2(1.58%) in the DAT group (p=0.424). Thrombocytopenia occurred in1(0.52%) patient in the TAT group and2(0.53%) in the DAT group (p=0.225).Conclusion:In patients undergoing long DES implantation, low-dose tirofiban, in addition to aspirin and clopidogrel, is safe and effective, and it reduces30-day incidence of MACE and ST without increasing the risks of bleeding complications or thrombocytopenia.