CLINICAL OUTCOMES OF COMBINED GLYCOPROTEIN IIB/IIIA INHIBITORS AND P2Y12 RECEPTOR ANTAGONIST IN ELECTIVE PCI FOR PATIENTS OVER 65

Introduction: Glycoprotein IIb/IIIa inhibitors (GPIs) are potent antiplatelet agents used during percutaneous coronary intervention (PCI) to reduce thrombotic complications. While their efficacy in acute coronary syndromes is established, their role in elective PCI, particularly among elderly patients, remains uncertain. Methods: This retrospective, single-center study included 85 patients aged ≥65 years who underwent elective PCI between 2021–2023 and received GPIs due to high thrombus burden or no-reflow. All patients received aspirin and a P2Y12 inhibitor (clopidogrel , prasugrel, or ticagrelor); abciximab or tirofiban was used as the GPI. Clinical, laboratory, and procedural data were analyzed, focusing on major bleeding, haemoglobin drop, transfusion requirement, and hospital stay. Results: The mean age was 70 years and 83% were male. Tirofiban was administered in 83% and abciximab in 17% of cases. Major bleeding occurred in 26%, most frequently in the abciximab plus potent P2Y12 group, though differences were not statistically significant. Hospital stay was longer in patients receiving abciximab. Haemoglobin drop was significantly greater across groups, but no difference was observed in haemoglobin levels at one-month and one-year follow-up. Creatinine values were comparable. No stent thrombosis or mortality was reported. Conclusions: In elderly patients undergoing elective PCI, GPIs appear to be the main determinant of bleeding risk, with no additional impact from the choice of P2Y12 inhibitor. These findings emphasize the need for a selective approach to GPI use in this setting.