Effects of Glycoprotein IIb/IIIa Receptor Inhibition on Early and Long-Term Prognosis in High-risk Patients with Non-ST Elevation Acute Coronary Syndromes Without Early Invasive Intervention

The aim of the study was to evaluate the effects of tirofiban on in-hospital, first month, and long-term major cardiac events in high-risk patients presenting with non-ST elevation acute coronary syndromes who were treated without early revascularisation. Twenty-nine male, 13 female total 42 patients (mean age 55±14, range 34-77) treated with aspirin, heparin, IV nitrate, beta-blocker or calcium channel blocker constituted the standard therapy (heparin) group, and (33 male, 8 female) a total of 41 patients (mean age 57±12, range 43-78) who additionally received tirofiban therapy constituted the tirofiban group. While the incidence of in-hospital total major cardiac events (27% vs. 54%, p: 0.01), recurrent refractory angina (%27 vs. 50%, p: 0.04), and acute myocardial infarction (2.4% vs. 19%, p: 0.03) was significantly lower in the tirofiban group, the incidence of death and urgent revascularisation was not different between the two groups. During the first 30 days of follow-up hospitalisation with unstable angina, acute myocardial infarction, revascularisation, death, heart failure, and stroke rates were not statistically different. Similarly the incidence of hospitalisation with unstable angina, acute myocardial infarction, revascularisation, death, and stroke was not statistically different during the long-term follow-up (11.8±2.4 months for tirofiban group, 9.5±2.7 months for the heparin group, p: NS), only the incidence of heart failure was more frequent with a borderline significance (p: 0.048) in the heparin group.
CONCLUSION
Tirofiban plus heparin therapy causes a decrease in in-hospital major cardiac events, but does not affect the 30-day, and long-term major cardiac events in high-risk patients presenting with non-ST elevation acute coronary syndrome who were treated without early revascularisation.