Tirofiban and eptifibatide treatment of patients presenting with acute coronary syndrome with non-ST segment elevation

Background In-hospital acquired thrombocytopenia (TP) is relatively common among patients hospitalized with acute coronary syndromes (ACS). However, its effect on short-term and long-term outcomes has yet to be reviewed systematically. Methods We conducted a systematic review and meta-analysis of clinical studies assessing the relationship between new-onset in-hospital TP and adverse outcomes among ACS patients. MEDLINE, Scopus and the Cochrane Library were searched for eligible studies published before March 20 2016. Results Ten studies reporting on a total of 142,161 ACS patients were identified. 8,133 patients showed evidence of new-onset TP during the course of their hospitalization. Compared with patients with normal platelet counts, patients with new-onset TP had a prolonged in-hospital stay, significantly higher risk of both short-term mortality (<30 days) (Odds ratio (OR) [95% confidence interval (CI)]: 5.58 [3.63–8.57]) and late death (6 months to 1 year) (OR [95%CI]: 3.45 [2.35–5.07]), as well as a significantly higher risk of major bleeding events in the first 30 days (OR [95%CI]: 6.93 [5.13–9.38]). In addition, risk for other secondary cardiovascular endpoints, including recurrent myocardial infarction, stroke, in-hospital heart failure, stent thrombosis and unplanned revascularization was also significantly higher in the TP versus the no TP group. Conclusions Development of TP during the in-hospital management of ACS patients is a significant predictor of both short- and long-term adverse events, including mortality. In the light of this evidence, clinicians should be cautious and closely monitor abnormal platelet counts that present early following an ACS.

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The effect of in-hospital acquired thrombocytopenia on the outcome of patients with acute coronary syndromes: A systematic review and meta-analysis

Oikonomou

Repanas²,

Papanastasiou

et al. 2016

Thrombosis Research

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Tirofiban and eptifibatide treatment of patients presenting with acute coronary syndrome with non-ST segment elevation

Abstract: This study shows that tirofiban and eptifibatide have been used optimally, with a close adherence to the pre-established protocol. Both drugs have shown a good level of tolerability.

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References 18 publications

The effect of in-hospital acquired thrombocytopenia on the outcome of patients with acute coronary syndromes: A systematic review and meta-analysis

The effect of in-hospital acquired thrombocytopenia on the outcome of patients with acute coronary syndromes: A systematic review and meta-analysis

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