Efficacy And Safety Of Low-dose Tirofiban In Elderly Femal Patien-Ts With Acute ST-segment Elevation Myocardial Infarction Under-Going Primary Percutaneous Coronary Intervention

Objective: To investigate the efficacy and safety of low-dose tirofiban in elderly femal patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PPCI).Methods: A total of 66 elderly patients who age ≥65 years with STEMI undergoing PPCI admitted to the Department of Cardiology in the Second Hospital of Hebei Medical University from January 2016 to January 2018 were enrolled in the study.There were 25 female and 41 male patients enrolled in this study.Both groups were given tirofiban a 10μg/kg bolus within 3 minutes,and then continuous intravenous infusion of 0.075μg/(kg.min)for 48 h.Baseline data,such as age and body mass index,were observed in the two groups,and the infarct-related artery(IRA)distribution,interventional characteristics,and incidence of bleeding complications were assessed.All data were processed using the SPSS21.0 statistical software,and P<0.05 was considered statistically significant.Results: The GRACE score and CRUSADE score in the elderly female group were higher than those in the elderly male group(141.76±6.16 vs.131.63±5.39,42.24±8.89 vs.30.2±4.46,both P<0.05).There was no statistical difference in TIMI grade 3 flow,postoperative ST segment fall rate,left ventricular functions,incidence of MACEs between the two groups(all P>0.05).During the treatment of tirofiban,the levels of platelet aggregation rate decreased significantly in both groups,and no differences were found between the two groups.At 8-hour after treatment,the levels of platelet aggregation rate were still lower than those in the baseline,and there were no significant difference between the two groups.The incidence of TIMI minor bleeding were higher in the elderly female group than those in the male group(40.0% vs.14.6%,P=0.020).No severe bleeding events and thrombocytopenia happened in both groups.Conclusion: The elderly female patient with STEMI are in higher ischemic and bleeding risks.The use of low-dose tirofiban in the elderly femal patients with STEMI could improve TIMI flow,without severe bleeding complications.