Abstract:

Objective To systematically review the effectiveness and safety of half-dose versus standard-dose of tirofiban for percutaneous coronary intervention (PCI) in elderly Chinese patients with acute coronary syndrome (ACS).Methods Randomized controlled trials(RCTs), which were about standard or half dose of tirofiban for elderly Chinese patients with ACS undergoing PCI, and published by Cochrane, PubMed, Embase, Wanfang, and CNKI databases until January 2021 at home and abroad, were retrieved. Secondly, meta-analysis was performed based on the literature review results, and publication bias was evaluated. Results Five articles were included out of 768 retrieved literatures, a total of 596 patients were enrolled, including 300 cases in the half-dose group and 296 cases in the standard-dose group. Meta-analysis showed that, the first, in terms of curative outcomes, there was no statistically significant difference in the incidences of grade III forward-flow of postoperative thrombolysis myocardial infarction (TIMI) and major adverse cardiovascular events(MACE) in clinical between groups (P>0.05). The second, in terms of safety, the incidence of clinical bleeding downregulated notably in half-dose group when compared with standard-dose group, and with statistically significant difference [RR=3.70, 95%CI=(1.89, 5.00), P<0.01]. The difference was not statistically significant in the incidence of thrombocytopenia between groups (P=0.61).Conclusion For elderly Chinese patients with ACS undergoing PCI, on the basis of conventional double antibodies, the safety of half-dose of tirofiban might be better than that of standard-dose, and the efficacy of two doses was equivalent.

Key words: acute coronary syndrome, aged, tirofiban, randomized controlled trial, meta-analysis