Key result
Low-dose tirofiban produced similar rates of major adverse cardiovascular events compared to medium and high doses but significantly reduced total bleeding events compared to high-dose tirofiban (10.3% vs 34.4%, p<0.05).
Why the study?
Balancing the efficacy of active antithrombotic therapy with bleeding reduction remains challenging in clinical practice.
Does the dose of tirofiban affect efficacy and bleeding outcomes in ACS patients undergoing PCI on dual antiplatelet therapy?
Cohort (n=347)
No
Does the dose of tirofiban affect efficacy and bleeding outcomes in ACS patients undergoing PCI on dual antiplatelet therapy?
p-value: p=0.606
A low dose of tirofiban combined with DAPT in ACS patients undergoing PCI maintains efficacy while significantly reducing bleeding complications compared to higher doses.
Retrospective ACS-PCI data on tirofiban dosing suggest variable efficacy-bleeding tradeoffs; leaves open need for randomized confirmation.
Challenges remain for clinicians over balancing the efficacy of active antithrombotic therapy and simultaneous bleeding reduction in patients. The clinical data of 347 patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) were retrospectively analyzed. On the basis of the given tirofiban, the patients were assigned into three different dose groups: high dose group (group H), medium dose group (group M), and low dose group (group L). The tirofiban efficacy was evaluated in terms of major adverse cardiovascular event (MACE) parameters and lab endpoints, including platelet count and function. The tirofiban safety was assessed by the occurrence of bleeding events. The patients were followed up for 1 month after the PCI. No significant difference in MACE events was evident among these groups (p > 0.05). Groups H and M reported an obvious reduction in platelet count (p < 0.05 for both) and an increased platelet inhibition rate (p < 0.05 for both). Group H showed a higher rate of total bleeding events than the other groups (Group H vs. Group M: 34.4% vs. 16.5%; Group H vs. Group L: 34.4% vs. 10.3%; p < 0.05 for both). A proper administration of a low dose of tirofiban may be a superior alternative in treating ACS patients, which can produce a similar favorable clinical outcome and a decrease in bleeding complication.
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Guo et al. (2021) conducted a cohort in Acute coronary syndrome (ACS) (n=347). Tirofiban vs. Different dose groups was evaluated on Major adverse cardiac events (MACEs) (p=0.606). Low-dose tirofiban produced similar rates of major adverse cardiovascular events compared to medium and high doses but significantly reduced total bleeding events compared to high-dose tirofiban (10.3% vs 34.4%, p<0.05).
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