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Abstract The aim of this study is to compare patients of NSTEACS (at low or intermediate risk) who were given GP IIb/IIIa antagonist (Tirofiban) and those who were not; to evaluate benefits gained both angiographically and clinically ( major adverse cardiac events i.e. recurrent ischemia, MI or death) The study population included 60 patients admitted to CCU of police authority hospital and presented with NSTEACS without elevation in cardiac biomarkers. Patients with STEMI as well as other high risk patients were excluded in this study. There was no significant difference between the two groups regarding baseline criteria (age, sex and other risk factors of CAD). All patients were subjected to full history taking, complete general and cardiac examination. Also 12 lead ECG, cardiac enzymes, lipid profile and echocardiography were done. All patients were treated by aspirin, clopidogrel and LMWH. Also nitrates, B-blockers, ACE inhibitors and statins were administered if not contraindicated. The 60 patients were randomly divided into 2 groups; group 1 (30 patients who were given Tirofiban) and group 2 (30 patients who were not given Tirofiban). All 60 patients had their coronary angiography done within 72 h from randomization and PCI was done after 48 h when needed. Regarding angiographic results; there were 15 patients with non-significant lesions; 7patients in group1 (23.3%) & 8patients in group2 (26.7%), 23patients were with single vessel disease; 12 patients in group1 (40%) & 11 patients in group2 (36.7%), 13 patients were with two vessels disease; 6 patients in group1 (20%) & 7 patients in group2 (23.3%) and 9 patients were with three vessels disease; 5 patients in group1 (16.7%) & 4 patients in group2(13.3%) Regarding presence of intra-coronary thrombus; there were 4 patients in group 1 (13.3%) & 3 patients in group 2 (10%) The difference between the 2 groups was not significant (p>0.05) Regarding procedure needed after coronary angiography, there were 15 patients for medical treatment; 7 in group 1 (23.3%) & 8 in group 2 (26.7%), 34 patients for PCI; 18 in group 1 (60%) & 16 in group 2 (53.3%) and 11 patients for CABG; 5 in group 1 (16.7%) & 6 in group 2 (20%). The difference between the 2 groups was not significant. The end point of the study was a composite of death from any cause, new myocardial infarction, or recurrent ischemia within 7 days after randomization. Regarding study end point, 6 patients had recurrent ischemia; 2 patients in group 1 (6.7%) and 4 patients in group 2 (13.4%) two of which developed NSTEMI. There were no deaths among study population. Although there was slight decrease in number of major adverse cardiac events in group 1, the difference was statistically insignificant (p>0.05) There was no major bleeding or thrombocytopenia among study population. |