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

Ju Han Kim; Myung Ho Jeong; Jay Young Rhew; Ji Hyun Lim; Kyung Ho Yun; Kye Hun Kim; Dong Koo Kang; Seo Na Hong; Sang Yup Lim; Sang Hyun Lee; Yeon Sang Lee; Young Joon Hong; Hyung Wook Park; Weon Kim; Young Keun Ahn; Yong Moon; Jeong Gwang Cho; Jong Chun Park; Jung Chaee Kang

doi:10.1253/circj.69.159

Clinical Investigation

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

Ju Han Kim, Myung Ho Jeong, Jay Young Rhew, Ji Hyun Lim, Kyung Ho Yun, Kye Hun Kim, Dong Koo Kang, Seo Na Hong, Sang Yup Lim, Sang Hyun Lee, Yeon Sang Lee, Young Joon Hong, Hyung Wook Park, Weon Kim, Young Keun Ahn, Yong Moon, Jeong Gwang Cho, Jong Chun Park, Jung Chaee Kang

Author information

Ju Han Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Myung Ho Jeong
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jay Young Rhew
The Heart Center of Jeonju Presbyterian Medical Center
Ji Hyun Lim
The Heart Center of Jeonju Presbyterian Medical Center
Kyung Ho Yun
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Kye Hun Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Dong Koo Kang
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Seo Na Hong
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Sang Yup Lim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Sang Hyun Lee
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Yeon Sang Lee
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Young Joon Hong
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Hyung Wook Park
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Weon Kim
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Young Keun Ahn
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Yong Moon
The Heart Center of Jeonju Presbyterian Medical Center
Jeong Gwang Cho
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jong Chun Park
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences
Jung Chaee Kang
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences

Keywords: Coronary disease, Heparin, Platelet aggregation inhibitors

JOURNAL FREE ACCESS

2005 Volume 69 Issue 2 Pages 159-164

DOI https://doi.org/10.1253/circj.69.159

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Abstract

Background Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. Methods and Results One hundred and sixty patients (60.9±11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban + heparin) and group IV (n=40: tirofiban + dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). Conclusions Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS. (Circ J 2005; 69: 159 - 164)

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