Objectives To observe the effect of tirofiban on cardiac markers, platelet aggregation rate and major adverse cardiac events (MACE) in patients with complex coronary artery disease undergoing elective PCI and discuss the safety and feasibility.
Methods Retrospectively enrolled 676 patients with complex coronary artery disease and divided into conventional treatment (n=364) group and tirofiban (n=312) group. Aspirin and clopidogrel were used in both groups and tirofiban was used in T-group at least 24 h. Observe cardiac markers (Troponin-I and Creatine kinase-MB), platelet aggregation rate and MACE (recurrent angina, revascularization, non-fatal myocardial infarction and cardiac death) at 6-month.
Results The baseline risk of the two groups were of no difference. Platelet aggregation rate (12% vs 41%, p=0.015), TnI (21% vs 68%, p=0.033) and CK-MB (14% vs 52%, p=0.016) at 24 h after procedure was lower in T-group than that in C-group. Recurrent angina (9.3% vs 14.3%, p=0.046) and MACE (17.3% vs 23.6%, p=0.043) at 6-month was lower in T-group than that in C-group. There was no significant difference in revascularization, non-fatal MI and cardiac death. Platelet count was similar in both groups (238±57×109/l vs 224±46×109/l, p=0.328). The minor bleeding events increased in T-group (8.2% vs 3.7%, p=0.024), there was 1 gastrointestinal bleeding and no intracranial haemorrhage in T-group.
Conclusions Tirofiban can decrease platelet aggregation rate, cardiac markers (TnI, CK-MB) and improve clinical outcomes at 6-month and it is safe and effective to use tirofiban in patients with complex coronary artery disease. These findings indicate that tirofiban is efficacious and safe in complex coronary artery disease patients undergoing elective PCI.