Clinical Efficacy And Safety Of Tirofiban In Patients With Coronary Heart Disease After PCI

ObjectiveTo investigate the clinical efficacy and safety of tirofiban in patients with acute coronary syndrome after PCI.MethodsThe study included 329 patients with acute coronary syndromes,including unstable angina pectoris(179 patients): simple stenting was performed on the basis of coronary angiography in group A(80 cases);complex stent treatment in group B(94 cases);acute myocardial infarction patients(150 cases): according to the results of coronary angiography,simple stent treatment was performed in group C(98 cases)and complex stent group D(57 cases).Patients in each group according to the application of tirofiban dose were divided into: control group(A0 group,B0 group,C0 group,D0 group)without postoperative application of tirofiban;low dose group(A1 group,B1 group,C1 group,D1 group)after tirofiban injection at a rate of0.08ug/kg/min to maintain the infusion for 36 hours;high dose group(A2 group,B2 group,C2 group,D2 group)after tirofiban injection to maintain the rate of 0.12ug/kg/min infusion for 36 hours.Comparison of major adverse cardiac events(stent thrombosis,cardiac function insufficiency,recurrent angina,myocardial infarction)the incidence of bleeding events were recorded,the incidence of thrombocytopenia syndrome,and analyzed statistically at the same time.Results1.The general clinical data of the subjects were selected: gender,age,smoking history,hypertension,diabetes mellitus,hyperlipidemia have no significant difference(P>0.05).2.The incidence of MACE events in group A,group B and group C was not statistically different at different doses(P>0.05);The incidence of MACE events in the D group was higher in group D0 than in the group D1(P=0.048).3.The bleeding events in group A were higher in the group A2 than in the group A1(P=0.024).The bleeding events in group B were higher in the group B2 than in the group B1(P=0.004);The bleeding events in the group C0 and the group C1 were not statistically significant(P=0.669)while the group C2 were higher than the group C1(P=0.031);There was no significant difference in bleeding events between group D(P=0.822).Conclusions1?For unstable angina patients with simple stent treatment,it is recommended to apply small dose tirofiban or no tirofiban.2.For the unstable angina patients with complex stent treatment,it is recommended to apply low-dose tirofiban.3.For small myocardial infarction patients undergoing simple stent implantation,a small dose tirofiban should be recommended.4,for complex stent implantation in patients with myocardial infarction,suggested that the application of small dose of tirofiban,such as coronary artery lesions in patients with severe to high-dose tirofiban,should closely monitor patients with platelet count,timely adjustment of tirofiban dosage.3,Different patients should be individualized medication,and according to the results of postoperative blood routine adjustment of medication.