Korean Circ J.  2003 Jul;33(7):559-567. 10.4070/kcj.2003.33.7.559.

The Long-Term Clinical Outcomes of Low Molecular Weight Heparin Combined with Platelet Glycoprotein IIb/IIIa Inhibitor in Patients with Acute Coronary Syndrome

Abstract

BACKGROUND AND OBJECTIVES
Platelet activation and aggregation, with resultant arterial thrombus formation, play pivotal roles in the pathophysiology of acute coronary syndrome (ACS). The efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin, or low molecular heparin (LMWH), in the management of ACS were evaluated. SUBJECTS AND MEHTODS: One hundred seventeen patients (60.8+/-10.9 years, 76 male), with unstable angina or non-ST elevation myocardial infarction, who had ST-T changes and elevated troponin, were divided into 4 groups : Group I (n=30 : heparin alone), Group II (n=28 : LMWH, dalteparin alone), Group III (n=29 : tirofiban combined with heparin) and Group IV (n=30 : tirofiban with LMWH). The major adverse cardiac events (MACE) among the 4 groups, during 6-month clinical follow-ups, were compared.
RESULTS
Percutaneous coronary intervention, or a coronary artery bypass graft, was performed in 23, 19, 19 and 22 patients from Groups I, II, III and IV, respectively (p=0.87). A minor bleeding complication developed in 2 (6.7%), 1 (3.6%), 1 (3.4%) and 2 patients (6.7%) in groups I, II, III and IV, respectively (p=0.79). During the six-month follow-up MACE occurred in 7 (30.4%), 6 (31.6%), 3 (15.8%) and 4 patients (18.2%) in groups I, II, III and IV, respectively (p=0.02 : Group I and II vs. Group III and IV).
CONCLUSION
Tirofiban combined with LMWH is safe and may improve the long-term prognosis of patients with ACS.

Keyword

Myocardial infarction; Thrombosis; Platelets; Angioplasty; Prognosis

MeSH Terms

Acute Coronary Syndrome*
Angina, Unstable
Angioplasty
Blood Platelets*
Coronary Artery Bypass
Dalteparin
Follow-Up Studies
Glycoproteins*
Hemorrhage
Heparin
Heparin, Low-Molecular-Weight*
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Platelet Activation
Prognosis
Thrombosis
Transplants
Troponin
Dalteparin
Glycoproteins
Heparin
Heparin, Low-Molecular-Weight
Troponin

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Kyung-Tae Jung, Soon-Chang Park, Yoo-Jung Choi, Sang Lee, Kyung-Jin Lee, Jung-Hee Kim, Hyun-Soo Yoon
J Cardiovasc Ultrasound. 2008;16(3):96-98.    doi: 10.4250/jcu.2008.16.3.96.

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