Effect of intracoronary plus low-dose intravenous tirofiban in elderly patients with acute myocardial infarction

Qiang Zhao, Yun He, Shu-Xiang Wang, Biao Li, Yuan-Jie Xu, Jing-Yun Luo, Wei-Guang Huang, Tong-Guo Wu, Lexin Wang

Research output: Contribution to journalArticle

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Abstract

Background: To investigate the efficacy and safety of low-dose tirofiban in elderly patients undergoing primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI). Methods: One hundred and four patients aged 70 years and above undergoing PPCI for AMI were divided into control (n=52) and study (n=52) groups. All patients received bolus intracoronary injection of tirofiban (10. µg/kg), which was followed by intravenous infusion at 0.15. µg/kg/min in the control group and at 0.075. µg/kg/min in the study group for 24. h. Results: There was no statistically significant difference between the study group and the control group in patients with complete ST segment resolution (84.2% vs. 85.7%, P= 0.851), peak high-sensitive cardiac troponin T level (5.1±1.9 vs. 5.8±2.6. µg/L, P= 0.123), scores of thrombus in the infarct-related artery (0.98±0.51 vs. 1.12±0.59, P= 0.214), and patients with TIMI grade 3 flow (86.0% vs. 88.2%, P=0.737) after PPCI. There were no statistically significant differences between the two groups in left ventricular ejection fraction (57.1±6.3 vs. 57.7±6.1, P=0.611) and composite major adverse cardiovascular events rate (P =0.778) at 90 days after PCI. The total bleeding rate in the study group was lower than in the control group (P= 0.048). Conclusion: In elderly patients with AMI undergoing primary PCI, low and standard dose of tirofiban exerts similar effects on platelet aggregation, coronary flow, infarct size, left ventricular systolic function and short-term clinical outcomes. Low dose regimen is associated with a lower bleeding rate than the standard dose. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).
Original languageEnglish
Pages (from-to)1062-1067
Number of pages6
JournalHeart Lung and Circulation
Volume24
Issue number11
DOIs
Publication statusPublished - Nov 2015

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tirofiban
Myocardial Infarction
Percutaneous Coronary Intervention
Control Groups
Hemorrhage
Troponin T
New Zealand
Platelet Aggregation
Left Ventricular Function
Intravenous Infusions
Stroke Volume
Thrombosis
Thorax
Arteries

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Zhao, Qiang ; He, Yun ; Wang, Shu-Xiang ; Li, Biao ; Xu, Yuan-Jie ; Luo, Jing-Yun ; Huang, Wei-Guang ; Wu, Tong-Guo ; Wang, Lexin. / Effect of intracoronary plus low-dose intravenous tirofiban in elderly patients with acute myocardial infarction. In: Heart Lung and Circulation. 2015 ; Vol. 24, No. 11. pp. 1062-1067.
@article{365e73c5098d41b5af7565d527101803,
title = "Effect of intracoronary plus low-dose intravenous tirofiban in elderly patients with acute myocardial infarction",
abstract = "Background: To investigate the efficacy and safety of low-dose tirofiban in elderly patients undergoing primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI). Methods: One hundred and four patients aged 70 years and above undergoing PPCI for AMI were divided into control (n=52) and study (n=52) groups. All patients received bolus intracoronary injection of tirofiban (10. {\^A}µg/kg), which was followed by intravenous infusion at 0.15. {\^A}µg/kg/min in the control group and at 0.075. {\^A}µg/kg/min in the study group for 24. h. Results: There was no statistically significant difference between the study group and the control group in patients with complete ST segment resolution (84.2{\%} vs. 85.7{\%}, P= 0.851), peak high-sensitive cardiac troponin T level (5.1±1.9 vs. 5.8±2.6. {\^A}µg/L, P= 0.123), scores of thrombus in the infarct-related artery (0.98±0.51 vs. 1.12±0.59, P= 0.214), and patients with TIMI grade 3 flow (86.0{\%} vs. 88.2{\%}, P=0.737) after PPCI. There were no statistically significant differences between the two groups in left ventricular ejection fraction (57.1±6.3 vs. 57.7±6.1, P=0.611) and composite major adverse cardiovascular events rate (P =0.778) at 90 days after PCI. The total bleeding rate in the study group was lower than in the control group (P= 0.048). Conclusion: In elderly patients with AMI undergoing primary PCI, low and standard dose of tirofiban exerts similar effects on platelet aggregation, coronary flow, infarct size, left ventricular systolic function and short-term clinical outcomes. Low dose regimen is associated with a lower bleeding rate than the standard dose. {\^A}{\circledC} 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).",
keywords = "Acute-heart-infarction, Aged, Article, Bleeding, Controlled-study, Coronary-artery-blood-flow, Drug-efficacy, Drug-safety, Female, Heart-infarction-size, Heart-left-ventricle-ejection-fraction, Heart-left-ventricle-function, Human, Tirofiban, Troponin-T",
author = "Qiang Zhao and Yun He and Shu-Xiang Wang and Biao Li and Yuan-Jie Xu and Jing-Yun Luo and Wei-Guang Huang and Tong-Guo Wu and Lexin Wang",
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doi = "10.1016/j.hlc.2015.04.161",
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Effect of intracoronary plus low-dose intravenous tirofiban in elderly patients with acute myocardial infarction. / Zhao, Qiang; He, Yun; Wang, Shu-Xiang; Li, Biao; Xu, Yuan-Jie; Luo, Jing-Yun; Huang, Wei-Guang; Wu, Tong-Guo; Wang, Lexin.

In: Heart Lung and Circulation, Vol. 24, No. 11, 11.2015, p. 1062-1067.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of intracoronary plus low-dose intravenous tirofiban in elderly patients with acute myocardial infarction

AU - Zhao, Qiang

AU - He, Yun

AU - Wang, Shu-Xiang

AU - Li, Biao

AU - Xu, Yuan-Jie

AU - Luo, Jing-Yun

AU - Huang, Wei-Guang

AU - Wu, Tong-Guo

AU - Wang, Lexin

N1 - Includes bibliographical references.

PY - 2015/11

Y1 - 2015/11

N2 - Background: To investigate the efficacy and safety of low-dose tirofiban in elderly patients undergoing primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI). Methods: One hundred and four patients aged 70 years and above undergoing PPCI for AMI were divided into control (n=52) and study (n=52) groups. All patients received bolus intracoronary injection of tirofiban (10. µg/kg), which was followed by intravenous infusion at 0.15. µg/kg/min in the control group and at 0.075. µg/kg/min in the study group for 24. h. Results: There was no statistically significant difference between the study group and the control group in patients with complete ST segment resolution (84.2% vs. 85.7%, P= 0.851), peak high-sensitive cardiac troponin T level (5.1±1.9 vs. 5.8±2.6. µg/L, P= 0.123), scores of thrombus in the infarct-related artery (0.98±0.51 vs. 1.12±0.59, P= 0.214), and patients with TIMI grade 3 flow (86.0% vs. 88.2%, P=0.737) after PPCI. There were no statistically significant differences between the two groups in left ventricular ejection fraction (57.1±6.3 vs. 57.7±6.1, P=0.611) and composite major adverse cardiovascular events rate (P =0.778) at 90 days after PCI. The total bleeding rate in the study group was lower than in the control group (P= 0.048). Conclusion: In elderly patients with AMI undergoing primary PCI, low and standard dose of tirofiban exerts similar effects on platelet aggregation, coronary flow, infarct size, left ventricular systolic function and short-term clinical outcomes. Low dose regimen is associated with a lower bleeding rate than the standard dose. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).

AB - Background: To investigate the efficacy and safety of low-dose tirofiban in elderly patients undergoing primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI). Methods: One hundred and four patients aged 70 years and above undergoing PPCI for AMI were divided into control (n=52) and study (n=52) groups. All patients received bolus intracoronary injection of tirofiban (10. µg/kg), which was followed by intravenous infusion at 0.15. µg/kg/min in the control group and at 0.075. µg/kg/min in the study group for 24. h. Results: There was no statistically significant difference between the study group and the control group in patients with complete ST segment resolution (84.2% vs. 85.7%, P= 0.851), peak high-sensitive cardiac troponin T level (5.1±1.9 vs. 5.8±2.6. µg/L, P= 0.123), scores of thrombus in the infarct-related artery (0.98±0.51 vs. 1.12±0.59, P= 0.214), and patients with TIMI grade 3 flow (86.0% vs. 88.2%, P=0.737) after PPCI. There were no statistically significant differences between the two groups in left ventricular ejection fraction (57.1±6.3 vs. 57.7±6.1, P=0.611) and composite major adverse cardiovascular events rate (P =0.778) at 90 days after PCI. The total bleeding rate in the study group was lower than in the control group (P= 0.048). Conclusion: In elderly patients with AMI undergoing primary PCI, low and standard dose of tirofiban exerts similar effects on platelet aggregation, coronary flow, infarct size, left ventricular systolic function and short-term clinical outcomes. Low dose regimen is associated with a lower bleeding rate than the standard dose. © 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ).

KW - Acute-heart-infarction

KW - Aged

KW - Article

KW - Bleeding

KW - Controlled-study

KW - Coronary-artery-blood-flow

KW - Drug-efficacy

KW - Drug-safety

KW - Female

KW - Heart-infarction-size

KW - Heart-left-ventricle-ejection-fraction

KW - Heart-left-ventricle-function

KW - Human

KW - Tirofiban

KW - Troponin-T

U2 - 10.1016/j.hlc.2015.04.161

DO - 10.1016/j.hlc.2015.04.161

M3 - Article

C2 - 26048317

VL - 24

SP - 1062

EP - 1067

JO - Heart Lung and Circulation

JF - Heart Lung and Circulation

SN - 1443-9506

IS - 11

ER -