Zhang Dapeng, Wang Lefeng, Wang Hongshi, Xu Li, Li Weiming, Ni Zhuhua, Xia Kun, Liu Yu, Yang Xinchun
Heart Center, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Mar;53(3):193-7.
To study the efficacy and safety of tirofiban in patients with acute non-ST- segment elevation myocardial infarction (NSTEMI) without early reperfusion intervention.
A total of 151 NSTEMI patients without early reperfusion intervention were enrolled in the study and randomized to the tirofiban group (n = 76) and the control group(n = 75). Coronary angiography was performed at day 3 and day 7, while percutaneous coronary intervention (PCI) was performed when necessary. Parameters including thrombolysis in myocardial infarction (TIMI) flow, bleeding complications and clinic events within 30 days were compared between the two groups.
Before PCI, no increase in the percentage of patient with TIMI flow better than TIMI-2 was observed by the treatment of tirofiban (69.3% vs 78.9%, P = 0.10). While after PCI, significant increase in the percentage of patient with TIMI flow better than TIMI-2 was manifested in the tirofiban group (96.0% vs 100.0%, P = 0.04). Tirofiban treatment also significantly decreased the rate of poor myocardial perfusion after PCI (19.7% vs 34.7%, P = 0.04). There were 0 and 4 major adverse cardiovascular events (MACE) within 30 days observed in the tirofiban group and the control group (0.0% vs 5.3%, P = 0.05). No difference between the two groups was found in the bleeding complications within 30 days including the mild hemorrhage (5 vs 4 cases, P = 0.75), severe hemorrhage (2 vs 1 cases, P = 0.56) or severe thrombocytopenia (2 vs 0 cases, P = 0.49).
Tirofiban treatment does not increase the bleeding complications in NSTEMI patients without early PCI. Tirofiban can improve the TIMI flow and the myocardial perfusion after PCI with less MACE within 30 days.
研究替罗非班在未进行早期再灌注干预的急性非ST段抬高型心肌梗死（NSTEMI）患者中的疗效及安全性。
共纳入151例未进行早期再灌注干预的NSTEMI患者，随机分为替罗非班组（n = 76）和对照组（n = 75）。在第3天和第7天行冠状动脉造影，必要时行冠状动脉介入治疗（PCI）。比较两组心肌梗死溶栓（TIMI）血流、出血并发症及30天内临床事件等参数。
PCI前，替罗非班治疗未观察到TIMI血流优于TIMI-2级的患者百分比增加（69.3% 对78.9%，P = 0.10）。而PCI后，替罗非班组TIMI血流优于TIMI-2级的患者百分比显著增加（96.0% 对100.0%，P = 0.04）。替罗非班治疗还显著降低了PCI后心肌灌注不良的发生率（19.7% 对34.7%，P = 0.04）。替罗非班组和对照组30天内分别观察到0例和4例主要不良心血管事件（MACE）（0.0% 对5.3%，P = 0.05）。两组30天内出血并发症无差异，包括轻度出血（5例对4例，P = 0.75）、严重出血（2例对1例，P = 0.56）或严重血小板减少症（2例对0例，P = 0.49）。
替罗非班治疗不会增加未早期行PCI的NSTEMI患者的出血并发症。替罗非班可改善PCI后的TIMI血流和心肌灌注，且30天内MACE较少。
