Analysis of Bleeding Complications in Acute Coronary Syndrome: Comparison of Effect of Tirofiban in Diabetic and Non-Diabetic Patients

Abstract

Background: Coronary artery disease (CAD) is the most prevalent manifestation of cardiovascular diseases and is associated with high mortality and morbidity. The clinical presentations of CAD include silent ischemia, stable angina pectoris, unstable angina, myocardial infarction (MI), heart failure, and sudden death. Objective: This study was designed to define the frequency of hemorrhagic complications and to identify clinical variables associated with increased risk of bleeding complications in diabetic versus non-diabetic patients presented with acute coronary syndrome whom received aspirin, clopidogrel and heparin only or in combination with GPIIb/IIIa receptors blockade (Tirofiban) and to detect any bleeding complications in all patients during the period of admission in the hospital. Patients and Methods: 150 patients with ACS were divided into two groups, 82 diabetic patients and 68 nondiabetic patients. 40 patients out of total sample received tirofiban. Assessment of in hospital TIMI bleeding, GRACE and CRUSADE risk scores was estimated for all of them. Results: We observed that, there is no statistically significant difference in TIMI bleeding in both heparin and tirofiban group in diabetic versus non-diabetic patients. Cardiac catheterization access site was the most frequent location of bleeding most likely secondary to the high rate of coronary angiography performed in the study. Tirofiban added to heparin did not increase the risk of bleeding at the vascular access site.Conclusion: There was no statistically significant increase in all TIMI bleeding, thrombocytopenia or blood transfusions with the combination of tirofiban with heparin in both diabetic and non-diabetic patients.