title: Outcomes at 6 months for the direct comparison of tirofiban and abciximab during percutaneous coronary revascularisation with stent placement: the TARGET follow-up study.
abstract: BACKGROUND
  Two placebo-controlled trials testing intravenous platelet glycoprotein IIb/IIIa antagonists in the setting of percutaneous coronary revascularisation with intracoronary stents have shown a durable reduction in ischaemic events to 6 months. These trials differed regarding their patient population, IIb/IIIa inhibitor, and reported extent of benefit. Whether a small-molecule agent affecting only the IIb/IIIa receptor would provide a similar outcome for ischaemic events and clinical restenosis at 6 months when directly compared with a monoclonal antibody known to affect several integrin receptors is unknown.
  
  
  METHODS
  In 18 countries at 149 hospitals, 4809 patients undergoing elective or urgent stent implantation were randomly assigned a bolus and infusion of tirofiban or abciximab. Patients were followed for 6 months for the occurrence of death, myocardial infarction, and any target-vessel revascularisation. The results at 30 days have been reported previously.
  
  
  RESULTS
  At 6 months the composite endpoint of death, myocardial infarction, and target-vessel revascularisation occurred in 356 (14.8%) patients who received tirofiban and 345 (14.3%) patients who received abciximab (hazard ratio 1.04, 95% CI 0.90-1.21; p=0.591). The rates for the individual endpoints were 191 (8.0%) versus 159 (6.6%) for myocardial infarction (hazard ratio 1.21, 95% CI 0.98-1.50; p=0.074), 26 (1.1%) versus 25 (1.0%) for death (1.04, 0.60-1.80; p=0.893), and 194 (8.1%) versus 208 (8.6%) for target-vessel revascularisation (0.93, 0.77-1.14; p=0.495).
  
  
  CONCLUSIONS
  At 6 months, tirofiban provided a similar level of overall protection to abciximab against the composite of death, myocardial infarction, and any target-vessel revascularisation.
authors.affiliation: Department of Cardiovascular Medicine and C5 (Cleveland Clinic Cardiovascular Coordinating Center), Cleveland Clinic Foundation, Cleveland, OH 44195, USA. molited@ccf.org
authors.forename: David J
authors.initials: DJ
authors.lastname: Moliterno
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Yakubov
authors.forename: Peter M
authors.initials: PM
authors.lastname: DiBattiste
authors.forename: Howard C
authors.initials: HC
authors.lastname: Herrmann
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Carlos
authors.initials: C
authors.lastname: Macaya
authors.forename: Franz-Josef
authors.initials: FJ
authors.lastname: Neumann
authors.forename: Diego
authors.initials: D
authors.lastname: Ardissino
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bassand
authors.forename: Lynn
authors.initials: L
authors.lastname: Borzi
authors.forename: Alan C
authors.initials: AC
authors.lastname: Yeung
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Harris
authors.forename: Laura A
authors.initials: LA
authors.lastname: Demopoulos
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Topol
mesh_terms: D000077284:Abciximab; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D023381:Endpoint Determination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D009204:Myocardial Revascularization; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban; D000077284:Abciximab