Percutaneous coronary intervention (PCI) is a commonly executed practice in patients with acute coronary syndrome (ACS). Anti-coagulation therapy is crucial to avoid bad ischemic events during and after Percutaneous coronary intervention PCI1.
Bivalirudin, is a synthetic thrombin inhibitor composed of 20 amino acid polypeptide. It has been recommended as anti-coagulant drug in PCI guidelines2. Tirofiban is a glycoprotein inhibitor that prevents platelet aggregation by blocking the fibrinogen conjunction and receptors.
Previous studies have shown the potential risks like incidences of stent thrombosis events, by using full dose of Bivalirudin treatment3. This accounts for a safe dosage therapy by combination of conventional and synthetic drugs
A combination of bivalirudin and tirofiban, is usually practically in clinical treatments to reduce the risks. This combination of tirofiban and conventional drug would provide more comprehensive and powerful anti-thrombotic effects4. But there is no data available showing safe combination dose amount for both drugs.
For this purpose researchers conducted a study in which they demonstrated the appropriate dose of bivalirudin based therapy by comparing bivalirudin+full dose of tirofiban group with bivalirudin+1/2 of full dose of tirofiban group, in patients with acute coronary syndrome (ACS)undergoing Percutaneous coronary intervention (PCI)5.
Researchers performed experiment in 525 patients that were divided into bivalirudin+a half dose of tirofiban group (half dose group) and bivalirudin+a full dose of tirofiban group (full dose group). For evaluation of efficacy index the thrombolysis in myocardial infarction (TIMI) flow grade, the cardiac function and major adverse cardiovascular events (MACE) were performed.
It was found that improvement of TIMI flow, cardiac function and the decreased incidence rates of MACE showed no significant differences between the two groups. The occurrence of bleeding events was also lower than full dose group.
Written by: Rabeeia
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18 August, 2019