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Objectives To evaluate the efficacy and safety of post procedure use of platelet glycoprotein Ⅱb/Ⅲa receptor inhibitor (PGI) or low molecular weight heparin (LMWH) in patients with acute coronary syndrome (ACS) undergoing dual anti-platelet loading therapy and percutaneous coronary intervention (PCI). Methods This was a prospective randomized grouping controlled study in 174 patients with ACS received aspirin 300 mg plus clopidogrel 600mg loading before PCI. After procedure,patients were randomized to intravenous tirofiban for 12-24 hours (tirofiban group) or subcutaneous enoxaparin for 5 days (enoxaparin group). Cardiac ischemic events,major bleeding complications,minor bleeding complications,thrombocytopenia,and vascular access complications in both groups were investigated. Results Cardiac ischemic events,major bleeding complications,minor bleeding complications,thrombocytopenia,and vascular access complications in tirofiban group were 8.0%,3.4%,6.8%,3.4%,and 3.4%,respectively. In enoxaparin group,aforementioned event rates were 7%,2.3%,6.0%,2.3%,and 5.8%,respectively. No statistical significance was found between two groups. Conclusions In the setting of dual anti-platelet medication loading and PCI for the treatment of ACS,it is effective to use tirofiban or enoxaparin for aggressive post procedure antithrombotic therapy. It comes with a very low major bleeding complication rate. Use of GPI for 12 to 24 hours was comparable to use of LMWH for 5 days in efficacy and safety.
Objectives To evaluate the efficacy and safety of post procedure use of platelet glycoprotein IIb / IIIa receptor inhibitor (PGI) or low molecular weight heparin (LMWH) in patients with acute coronary syndrome (ACS) undergoing dual anti-platelet loading therapy and percutaneous coronary intervention (PCI). Methods This was a prospective randomized grouping controlled study in 174 patients with ACS received aspirin 300 mg plus clopidogrel 600 mg loading before PCI. After procedure, patients were randomized to intravenous tirofiban for 12-24 hours (tirofiban group) or subcutaneous enoxaparin Cardiac ischemic events, major bleeding complications, minor bleeding complications, thrombocytopenia, and vascular access complications in both groups were. Results Cardiac ischemic events, major bleeding complications, minor bleeding complications, thrombocytopenia, and vascular access complications in tirofiban group were 8.0%, 3.4%, 6.8%, 3.4%, and 3.4% respectively. Conclusions In the setting of dual anti-platelet coatings loading and PCI for the treatment of ACS, it is effective to use tirofiban or enoxaparin for aggressive post procedure antithrombotic therapy. It comes with a very low major bleeding complication rate. Use of GPI for 12 to 24 hours was comparable to use of LMWH for 5 days in efficacy and safety.