Tailoring treatment with tirofiban in patients showing resistance to aspirin and/or resistance to clopidogrel (3T/2R). Rationale for the study and protocol design.
OBJECTIVE
To assess whether glycoprotein IIb/IIIa inhibition using tirofiban in low risk patients undergoing percutaneous coronary intervention (PCI) may reduce the risk of periprocedural myocardial infarction compared to standard care in poor responders to aspirin and/or clopidogrel.


METHODS
We will enroll patients at ten European sites or more to participate in the Tailoring Treatment with Tirofiban in patients showing Resistance to aspirin and/or Resistance to clopidogrel (3T/2R) study with a pre-specified sample size of 240 patients out of 1,100 or more who will undergo screening. The primary outcome measure is troponin I or T elevation ratio at least three times the upper limit of normal within 48 h after completion of the PCI.


CONCLUSIONS
The results of 3T/2R study will evaluate whether tailored intensification of anti-platelet treatment based on poor individual response to oral anti-platelet agents may modulate the risk of periprocedural myocardial infarction during PCI. Our findings attempt at unraveling a new era of individualized anti-platelet treatment through the use of point-of-care assessment.
Valgimigli
Marco
M
University of Ferrara, Cardiovascular Institute, Arcispedale S. Anna Hospital, Corso Giovecca 203, 44100 Ferrara, Italy. vlgmrc@unife.it
Campo
Gianluca
G
de Cesare
Nicoletta
N
Vranckx
Pascal
P
Hamon
Martial
M
Angiolillo
Dominick J
DJ
Sabatè
Manel
M
Ferrari
Fabrizio
F
Furgieri
Alessandro
A
Tumscitz
Carlo
C
Repetto
Alessandra
A
Colangelo
Salvatore
S
Meliga
Emanuele
E
Kubbajeh
Moh'd
M
Parrinello
Giovanni
G
Percoco
Gianfranco
G
Ferrari
Roberto
R
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001241:Aspirin / Q000008:administration & dosage*; D015415:Biomarkers / Q000097:blood; D000077144:Clopidogrel; D004311:Double-Blind Method; D004351:Drug Resistance; D005060:Europe; D006801:Humans; D009203:Myocardial Infarction / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011446:Prospective Studies; D012107:Research Design; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D000077466:Tirofiban; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives*
D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D019210:Troponin I; D020107:Troponin T; D014443:Tyrosine; D000077144:Clopidogrel; D000077466:Tirofiban; D013988:Ticlopidine; D001241:Aspirin