ISSN 1016-5169 | E-ISSN 1308-4488
In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2022; 50(5): 320-326 | DOI: 10.5543/tkda.2022.21311

In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors

Sinan Akıncı1, Ali Çoner1, Ertan Akbay1, Adem Adar1, Ibrahim Haldun Müderrisoğlu2
1Department of Cardiology, Başkent University School of Medicine, Alanya Application and Research Center, Antalya, Turkey
2Department of Cardiology, Başkent University School of Medicine, Ankara, Turkey


OBJECTIVE
In this study, we aimed to determine whether potent agents affect in-hospital bleeding and mortality compared to clopidogrel in patients with the acute coronary syndrome in whom tirofiban and P2Y12 inhibitor are used together.


METHODS
Patients who were treated interventionally between 2015 and 2020 and were using tirofiban were retrospectively screened. Clinical, laboratory, and angiographic findings were obtained from the hospital database. Patients were analyzed by dividing them into clopidogrel and prasugrel/ticagrelor groups.


RESULTS
Acute coronary syndrome patients (n = 227) who were treated interventionally were included in this retrospective study. Clopidogrel was given to 93 (41%), ticagrelor to 112 (49.3%), and prasugrel to 22 of the patients (9.7%). Compared to the ticagrelor/prasugrel group, the clopidogrel group was older and more were women, and the history of hypertension
and previous coronary artery disease was higher (P, respectively: <.001;.001;.008;.0045). The creatinine value was higher, the basal hemoglobin was lower, and the GRACE (Global Registry of Acute Coronary Events) and CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) scores
were higher (P, respectively: .026;.002;.002; <.001). The in-hospital bleeding rate was significantly higher in the clopidogrel group (P <.001). Although the in-hospital mortality rate was higher, it was not statistically significant (P =.07). Regression analysis showed that GRACE score and gender were associated with in-hospital mortality (P <.001; P =.031, respectively), and only age was associated with in-hospital bleeding (P <.001). No relationship was found with P2Y12 inhibitor.


CONCLUSION
In our study, we found that the combined use of potent P2Y12 inhibitor with tiro-fiban in acute coronary syndrome patients treated interventionally was not different from the use of clopidogrel in terms of in-hospital bleeding and mortality.

Keywords: Acute coronary syndrome, bleeding, mortality, p2y12 receptor antagonist, tirofiban

Corresponding Author: Sinan Akıncı
Manuscript Language: English
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Akıncı, S., Çoner, A., Akbay, E., Adar, A., & Müderrisoğlu, I. H. (2022). In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors. Turk Kardiyol Dern Ars, 50(5), 320-326. https://doi.org/10.5543/tkda.2022.21311.
Akıncı S, Çoner A, Akbay E, Adar A, Müderrisoğlu IH. In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors. Turk Kardiyol Dern Ars. 2022 July;50(5):320-326. doi:10.5543/tkda.2022.21311.
Akıncı S, Çoner A, Akbay E, et al. In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors. Turk Kardiyol Dern Ars. 2022;50(5):320-326. doi:10.5543/tkda.2022.21311.
Akıncı, Sinan et al. "In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors." Turk Kardiyol Dern Ars vol. 50,5 (2022): 320-326. doi:10.5543/tkda.2022.21311.
Akıncı, Sinan, Ali Çoner, Ertan Akbay, Adem Adar and Ibrahim Haldun Müderrisoğlu "In-Hospital Bleeding and Mortality in Acute Coronary Syndrome Patients Treated with Tirofiban and Potent P2Y12 Inhibitors." Turk Kardiyol Dern Ars 50, no. 5 (2022): 320-326. https://doi.org/10.5543/tkda.2022.21311.
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