Tirofiban for myocardial infarction.
BACKGROUND
Inhibition of platelet aggregation plays a key role in treatment of coronary artery disease.


METHODS
Studies on the effects of tirofiban in patients with either ST elevation or non-ST elevation myocardial infarction are reviewed.


RESULTS
Tirofiban is a small-molecule glycoprotein IIb/IIIa receptor inhibitor. If discontinued, the action of tirofiban is faster reversed as abciximab. The dose varied between low (bolus of 0.4 microg/kg administered over 30 min followed by an infusion of 0.10 microg/kg/min), intermediate (bolus of 10 microg/kg administered over 3 min followed by an infusion of 0.15 microg/kg/min) and high (bolus of 25 microg/kg administered over 3 min followed by an infusion of 0.15 microg/kg/min). The high-dose administration especially may be beneficial in patients with ST elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). There is no indication for tirofiban in patients treated with thrombolysis. Patients with non-ST elevation myocardial infarction requiring PCI are most likely to benefit from tirofiban if they have ongoing ischemia and/or dynamic ECG changes. The risk of serious bleeding with tirofiban is low and there is a very low risk of thrombocytopenia.


CONCLUSIONS
Use of tirofiban for myocardial infarction is effective and has an acceptable safety profile.
Juwana
Yahya B
YB
Hospital Cinere, Cardiovascular Center, Jakarta, Indonesia.
Suryapranata
Harry
H
Ottervanger
Jan Paul
JP
van 't Hof
Arnoud W J
AW
D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors; D013921:Thrombocytopenia / Q000139:chemically induced; D000077466:Tirofiban; D014443:Tyrosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban