Comparison on Anticoagulation and Antiplatelet Aggregation Effects of Puerarin with Heparin Sodium and Tirofiban Hydrochloride: An In Vitro Study

Objective： To detect the anticoagulation and antiplatelet effects of different concentrations of puerarin, heparin sodium and tirofiban hydrochloride on the blood samples of healthy volunteers by Sonoclot coagulation and platelet function analyzer. Methods： Peripheral blood samples were extracted from 20 healthy volunteers, followed by adding different concentrations of puerarin, heparin sodium and tirofiban hydrochloride. Samples were detected for activated clotting time（ACT）, clot rate（CR） and platelet function（PF） by Sonoclot coagulation and platelet function analyzer instrument. Results： For puerarin and heparin sodium, the values of ACT gradually increased, and the values of CR and PF gradually decreased with increasing in drug concentration. There was a linear（or log linear） relationship between ACT, CR, PF value and drug concentration（P〈0.01）. Corresponding to each value, a regression equation was obtained. For tirofiban hydrochloride, the values of ACT and CR had no significant changes, while PF values gradually decreased with concentration increasing. There was also a linear relationship between PF values and concentrations of tirofiban hydrochloride（P〈0.01）. Under the same ACT values, the puerarin corresponding CR values（CR = e^（-0.0062） ACT＋4.31, P〈2.2 e^（-16）） were always higher than the corresponding values（CR = e-^（0.0028） ACT＋2.79, P-value〈2.2 e^（-16）） of heparin sodium. For high concentrations of puerarin（e.g. 3.8 mg/600 μL） and tirofiban hydrochloride（e.g. 0.8 μg/600 μL）, PF values had no significant difference. However, PF values for high puerarin concentration had a larger variance. Conclusions： Puerarin has similar anticoagulant and antiplatelet effects with the heparin sodium, and may have a lower hemorrhage risk than heparin sodium when obtained the same anticoagulation effect in the concentration range of this experiment. In addition, for high concentration, puerarin had the same antiplatelet function as tirofiban hydrochloride but with a larger individual variability.

Nursing observation of transradial coronary intervention combined with tirofiban hydrochloride for acute coronary syndrome in elderly patients

Background As the most effective approach in treatment of revascularization in coronary perfusion for acute coronary syndromes（ACSs）, percutaneous coronary intervention（PCI） can also increase the risk of detachment of thrombus and embolism of distal microcirculation. Tirofiban hydrochloride is a reversible antagonist of platelet glycoprotein Ⅱb / Ⅲa receptor, which can inhibit platelet aggregation quickly. However,it may also increase the risk of bleeding when in combination with other anti-thrombus drugs. It is important in medication observation for charge nurse when using Ⅱ b / Ⅲ a receptor inhibitor. Methods For 116 elderly patients with ACS who had transradial coronary interventional therapy combined with tirofiban hydrochloride,we conducted medication care, nursing observation of hemorrhage, nursing of puncture of upper limb,postoperative adverse cardiovascular events, observation of myocardial perfusion, blood flow and health education. Results A total of 10 patients had mild bleeding, no serious bleeding, and 2 with major adverse cardiac event（MACE）. Conclusions Tirofiban hydrochloride after PCI can significantly reduce cardiovascular events in acute coronary syndromes, but there is an increased risk of bleeding. It showed that strengthen inspection, closely observe condition and detecting bleeding in time after PCI can significantly reduce postoperative complications for charge nurses.