title: Impact of adjunctive tirofiban administration on myocardial perfusion and mortality in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction.
abstract: Several studies have shown that suboptimal myocardial perfusion may be observed despite optimal epicardial recanalisation in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI), resulting in unfavourable outcome. The aim of the current study was to evaluate the benefits in myocardial perfusion and mortality from adjunctive tirofiban administration in patients undergoing primary angioplasty for (STEMI). Atotal of 1,969 patients with STEMI treated by primary angioplasty represent the population of the current study. All clinical, angiographic and follow-up data were prospectively collected. Tirofiban was administrated in 481 patients (24.4%) (all before angioplasty). Tirofiban was associated with less distal embolisation (11.7% vs 16.1%, p = 0.048), better postprocedural MBG 3 (50.9% vs 39.7%, adjusted p < 0.0001) and a significant reduction in 1-year mortality (3% vs 6.4%, adjusted p = 0.045). The benefits in mortality were confirmed in all subgroups identified according to the quartiles of the propensity score. This study shows that, when compared to control group, adjunctive tirofiban before primary angioplasty for STEMI is associated with better myocardial perfusion and a reduction in 1-year mortality.
authors.affiliation: Department of Cardiology, ISALA Klinieken, Zwolle, The Netherlands.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
authors.forename: Jaap J
authors.initials: JJ
authors.lastname: Smit
authors.forename: Nicolette
authors.initials: N
authors.lastname: Ernst
authors.forename: Harry
authors.initials: H
authors.lastname: Suryapranata
authors.forename: Jan Paul
authors.initials: JP
authors.lastname: Ottervanger
authors.forename: Jan C A
authors.initials: JC
authors.lastname: Hoorntje
authors.forename: Jan-Henk E
authors.initials: JH
authors.lastname: Dambrink
authors.forename: A T Marcel
authors.initials: AT
authors.lastname: Gosslink
authors.forename: Menko-Jan
authors.initials: MJ
authors.lastname: de Boer
authors.forename: Arnoud W J
authors.initials: AW
authors.lastname: van 't Hof
mesh_terms: D000368:Aged; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000494:pharmacology*; D005500:Follow-Up Studies; D006321:Heart / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000628:therapy*; D015425:Myocardial Reperfusion; D009206:Myocardium / Q000473:pathology*; D010477:Perfusion; D020521:Stroke / Q000628:therapy; D013997:Time Factors; D000077466:Tirofiban; D014443:Tyrosine / Q000031:analogs & derivatives* / Q000494:pharmacology*
chemical_list: D005343:Fibrinolytic Agents; D014443:Tyrosine; D000077466:Tirofiban