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Objective To investigate the efficacy and safety of tirofiban in the treatment of aged patients with acute coronary syndrome (ACS) during primary percutaneous coronary intervention (PCI). Methods Two hundred and fifty-six patients with ACS who underwent primary PCI were randomly divided into two groups: tirofiban group (tirofiban + PCI treatment, n= 130) and control group (routine PCI treatment, n = 126). Tirofiban group was further divided into two subgroups according to the age: aged group(age ≥60 years, n= 68) and non-elderly group(age<60 years, n=62). At the end of PCI procedure, angiographic features such as thrombolysis in myocardial infarction (TIMI) flow grade, corrected TIMI frames count and TIMI myocardial perfusion grades (TMPG) were analyzed immediately. The incidence of major adverse cardiac events (MACE) was observed within 36 hours and 30 days after PCI, and the incidence rates of thrombocytopenia and bleeding were assessed. Results There was no significant difference between both the two study groups and the two subgroups in the basic clinical or angiographic characteristics before PCI (all P>0.05). There was no significant difference between two groups in TIMI 3 flow achievement rate in culprit vessels after PCI (93.6% vs. 91.3%, χ~2 = 1.02, P= 0.313). In tirofiban group, corrected TIMI frames count was significantly higher than that in control group (31.6±7.7 vs. 23.8±6.1, t = 2.49, P 0.026), and TMPG 3 achievement rate was also higher (83.1% vs. 67.5% ,χ~2=4.05, P=0.046). The incidence of MACE was significantly lower in tirofiban group than that in control group both within 36 hours and 30 days after procedure(6.9% vs. 19.0%, χ~2= 6.30, P= 0.013; 3.8% vs. 11.90%, χ~2= 5.82,P=0.018, respectively). No statistical difference was found in mild bleeding complications between the two groups (20.2% vs. 15.2%, χ~2 =3.65, P=0.065), but the incidence of mild bleeding was higher in aged group than that in the non-elderly group(25.0% vs. 14.5%,χ~2=4.98, P=0.026), and the incidences of serious bleeding and thrombocytopenia were similar between the two subgroups. Conclusions Intravenous tirofiban infusion is safe in aged ACS patients during primary PCI, and has favorable short-term outcomes compared with routine treatment, although there is a slight risk of mild bleeding.
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Objective To investigate the diagnostic value of the combination of exercise electrocardiography test(EET) and coronary artery calcification(CAC) determined by electron beam computed tomography(EBCT) in coronary artery disease.Methods One hundred and thirty-five patients underwent coronary angiography,EET and EBCT.The value of calcium score(CS) and EET in diagnosing coronary artery disease were separately and unitedly evaluated.Results According to calcification score cut points by age and gender,the sensitivity,specificity,positive and negative predictive value of CAC for diagnosing coronary artery disease were 77%,81%,74% and 83%,respectively.The corresponding parameters of EET were 73%,76%,68% and 80%.After combining CAC and EET,the sensitivity and negative predictive value of parallel test were 93% and 92%,and the specificity and positive predictive value were 96% and 91%,respectively.Conclusions Exercise electrocardiography test combined with coronary artery calcification determined by electron beam computed tomography can significantly improve their diagnostic value for coronary artery disease.
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Objective To investigate the short-term effect of PTCA on contractile function of hibernating myocardium. Methods Fifty-three patients with coronary heart disease and segmental dysfunction underwent echocardiography and radionuclide imaging. Echocardiography was repeated one week after PTCA. Results (1) Recovery of contractile function occurred in 87 revascularized segments with dysfunction (87/167, 52.1%) compared with only 2 nonrevascularized segments (2/59, 3.4%) (P
