Efficacy and Safety of Standard‐Dose Versus Half‐Dose Tirofiban in Patients with Non‐ST Elevation Acute Coronary Syndromes Undergoing Early Percutaneous Coronary Intervention. Issue 4 (18th July 2013)

• Record Type: Journal Article
• Authors: Li, Wei; Fu, Xianghua; Xue, Haiwei; Wang, Yanbo; Wang, Xuechao; Zhao, Yujun; Geng, Wei; Yang, Zengxin; Gu, Xinshun; Hao, Guozhen; Jiang, Yunfa; Fan, Weize; Wu, Weili; Li, Shiqiang
• Is Part Of: Cardiovascular therapeutics. Volume 31:Issue 4(2013:Aug.)
• Page Start: 210
• Page End: 214
• Publication Date: 2013-07-18
• Subjects: Cardiovascular pharmacology -- Periodicals; Cardiovascular agents -- Periodicals; Cardiovascular system -- Diseases -- Chemotherapy -- Periodicals; Cardiovascular Agents -- Periodicals; Cardiovascular Diseases -- drug therapy -- Periodicals; Agents cardiovasculaires -- Périodiques; Appareil cardiovasculaire -- Maladies -- Chimiothérapie -- Périodiques; 616.1005
• DOI: 10.1111/1755-5922.12004
• Languages: English
• ISSNs: 1755-5914

Abstract

<abstract abstract-type="main" id="cdr12004-abs-0001"> <title>Summary</title> <sec id="cdr12004-sec-0001" sec-type="section"> <title>Introduction</title> <p>To explore the optimal dosage of tirofiban associated with double benefits of efficacy and safety in patients with non‐ST elevation acute coronary syndromes (NSTE‐ACS) undergoing early percutaneous coronary intervention (PCI).</p> </sec> <sec id="cdr12004-sec-0002" sec-type="section"> <title>Aims</title> <p>A total of 163 patients were included in this study (78 in SD group versus 85 in HD group). In SD (HD) group, tirofiban was administered intravenously with a bolus dose of 10 (5) μg/kg within 3 min and followed by continuous intravenous infusion of 0.15 (0.075) μg/kg/min for 48 h. Within 24 h on admission, patients underwent CAG or CAG+PCI. The angiographic results (initial TIMI, final TIMI/CTFC/TMPG) were evaluated. Platelet aggregation rate (PAR) was measured before and 2, 24, 48 h after bolus tirofiban. MACEs were evaluated at 7‐day, 30‐day, and 6‐month follow‐up. Bleeding was observed at 7 days.</p> </sec> <sec id="cdr12004-sec-0003" sec-type="section"> <title>Results</title> <p>The proportions of TIMI grade 3 seemed higher in SD group before and after PCI followed by a better myocardial perfusion, but not statistically different (<italic>P</italic> = 0.26/0.08). PAR was lower in SD group than that in HD group at 2 h after bolus tirofiban (<italic>P </italic>= 0.03). MACEs were not statistically different at 7, 30 day, and 6 month in two groups. The incidence of minor bleeding was significantly lower in HD group than that in SD group (8.2% vs. 20.5%, <italic>P </italic>= 0.04). The risk of bleeding would increase under the conditions of decreased PAR, increased dose of tirofiban and decreased CCr.</p> </sec> <sec id="cdr12004-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Half‐dose tirofiban was not inferior to standard‐dose in efficacy, what is more, half‐dose tirofiban showed a better safety characteristic of lower bleeding risk. Therefore, half‐dose tirofiban is recommended to patients with NSTE‐ACS undergoing early PCI.</p> </sec> </abstract>