title: Adjunctive platelet glycoprotein IIb/IIIa receptor inhibition with tirofiban before primary angioplasty improves angiographic outcomes: results of the TIrofiban Given in the Emergency Room before Primary Angioplasty (TIGER-PA) pilot trial.
abstract: BACKGROUND
  Previous work has suggested that platelet glycoprotein IIb/IIIa receptor blockade may confer benefit in the treatment of acute myocardial infarction. The TIGER-PA pilot trial was a single-center randomized study to evaluate the safety, feasibility, and utility of early tirofiban administration before planned primary angioplasty in patients presenting with acute myocardial infarction.
  
  
  RESULTS
  A total of 100 patients presenting with acute myocardial infarction were randomized to either early administration of tirofiban in the emergency room or later administration in the catheterization laboratory. The primary outcome measures were initial TIMI grade flow, corrected TIMI frame counts, and TIMI grade myocardial perfusion ("blush"). Thirty-day major adverse cardiac events were also assessed. Angiographic outcomes demonstrate a significant improvement in initial TIMI grade flow, corrected TIMI frame counts, and TIMI grade myocardial perfusion when patients are given tirofiban in the emergency room before primary angioplasty. The rate of 30-day major adverse cardiac events suggests that early administration may be beneficial.
  
  
  CONCLUSIONS
  This pilot study suggests that early administration of tirofiban improves angiographic outcomes and is safe and feasible in patients undergoing primary angioplasty for acute myocardial infarction.
authors.affiliation: Stanford University Medical Center, Division of Cardiovascular Medicine, Stanford, Calif 94305, USA. dplee@stanford.edu
authors.forename: David P
authors.initials: DP
authors.lastname: Lee
authors.forename: Niall A
authors.initials: NA
authors.lastname: Herity
authors.forename: Bonnie L
authors.initials: BL
authors.lastname: Hiatt
authors.forename: William F
authors.initials: WF
authors.lastname: Fearon
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Rezaee
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Carter
authors.forename: Michelle
authors.initials: M
authors.lastname: Huston
authors.forename: Donald
authors.initials: D
authors.lastname: Schreiber
authors.forename: Peter M
authors.initials: PM
authors.lastname: DiBattiste
authors.forename: Alan C
authors.initials: AC
authors.lastname: Yeung
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017024:Chemotherapy, Adjuvant; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000628:therapy; D010865:Pilot Projects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*
chemical_list: D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban