Efficacy And Safety Of Low-dose Tirofiban In Peri-PCI Female Patients With STEMI

BackgroundTirofiban is beneficial to the patients with acute ST-segment elevation myocardial infarction(STEMI).At present,the dosage and duration of tirofiban in perioperative female STEMI patients receiving PCI are still unknown.ObjectiveTo investigate the efficacy and safety of low-dose tirofiban in perioperative female STEMI patients receiving PCI.MethodsReview 96 female patients with STEMI undergoing primary PCI in the coronary care unit,The First Affiliated Hospital of Zhengzhou University from January 1,2016 to December 31,2018.The patients were divided into two groups,standard dose group(n = 53)and low dose group(n = 43),according to the dosage of tirofiban.In standard dose group,10 ug/kg tirofiban were given to the patients by intravenous injection during the operation,the medicated speed was 0.1~0.15μg/kg/min during 36~48 hours post-operation.In low dose group,5 ug/kg tirofiban were given to the patients by intravenous injection during the operation,the medicated speed was 0.05~0.1μg/kg/min during 24~36 hours post-operation.Record the postoperation thrombolysis in myocardial infarction(TIMI)flow,90 min ST-segment resolution(STR),the safety endpoint and major adverse cardiac events during hospitalization and within 30 days post-discharge.The safety endpoints include fatal hemorrhage,non-fatal hemorrhage and thrombocytopenia.And major adverse cardiac events(MACE)include all-cause death,recurrent myocardial infarction and acute criminal revascularization.ResultsThe basic information in two groups was no significant difference(P>0.05).The infarct-related artery,number of vascular lesions and the average number of stent implantation in two groups was no significant difference(P>0.05).The comparison of temporary pacemaker,intra-aortic ballon pump and thrombus aspiration catheter in two groups was no significant difference(P>0.05).The TIMI blood flow after postoprative infarction-related vessel opening and 90 minSTR in two groups was no significant difference(P>0.05).During hospitalization,the incidence rates of Non-fatal hemorrhage of standard-dose group were significant higher than low-dose group(24.53% vs 6.98%,P=0.02).The incidence rates of fatal hemorrhage and thrombocytopenia in two groups was no significant difference(P>0.05).Post-discharge 30 days,the incidence rates of Non-fatal hemorrhage of standard-dose group were significant higher than low-dose group(30.19% vs 11.63%,P=0.03).The incidence rates of fatal hemorrhage and thrombocytopenia in two groups was no significant difference(P>0.05).During hospitalization and post-discharge 30 days the incidence rates of MACE in two groups was no significant difference(P>0.05).ConclusionLow-dose tirofiban can reduce the risk of Non-fatal hemorrhage and can not affect clinical efficacy compared with standard-dose tirofiban in Peri-PCI Female Patients with STEMI.