Efficacy and Safety of Tirofiban in Patient Undergoing Planned Percutaneous Coronary Intervention Based on Real-world Evidence: A Retrospective Study of 1311 Patients

Abstract

Abstract Background There is no consensus on reductions of ischemic events and bleeding risks of tirofiban for patients receiving planned percutaneous coronary intervention (PCI) yet. In this study, we aim to investigate the real-world efficacy and safety of tirofiban treatment on patients undergoing planned PCI during hospital course and explore potential population who could benefit from tirofiban. Methods This real-world study included 1311 patients who received planned PCI and implanted stents. Demographic and clinical characteristics were compared between patients who received tirofiban treatment (n = 829) and those were not given tirofiban as control (n = 482). Correlation of tirofiban and outcome in hospital level was assessed using logistic regression analysis. Results More tirofiban patients had multivessel disease and multiple stents implantation. On logistic regression analysis, there was no significant association between the usage of tirofiban and bleeding events (OR [95%CI] = 1.36 [0.65,3.06], p = 0.433), major adverse cardiac and cerebrovascular events (MACCE) (OR [95%CI] = 1.37 [0.65, 3.06], p = 0.425) or net adverse cardiac and cerebrovascular events (NACCE) (OR [95%CI] = 1.01 [0.61, 1.71], P = 0.963). In subgroup analysis, tirofiban used among patients with higher D-dimer level (D-dimer ≥ 0.5 g/ml FEU) was less likely to be associated with MACCE (OR = 0.51 vs OR = 4.59, p for interaction = 0.031). Conclusions The use of tirofiban did not decrease MACCE or NACCE during hospital course among patients undergoing planned PCI, however, the risk of bleeding was not increased. Tirofiban receipts were prone to severe illness and complex PCI. Conferring no harm but potential benefits, the use of tirofiban could be considered for patients who received planned PCI and present with comorbidities and complex coronary lesions.