title: Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction.
abstract: We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.
authors.affiliation: Cardiology Department, Ankara University, Ibni Sina Hastanesi, 06600 Ankara, Turkey. Basarcandemir@yahoo.com
authors.forename: Basar
authors.initials: B
authors.lastname: Candemir
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kilickap
authors.forename: Ozgur Ulas
authors.initials: OU
authors.lastname: Ozcan
authors.forename: Cansin Tulunay
authors.initials: CT
authors.lastname: Kaya
authors.forename: Menekse
authors.initials: M
authors.lastname: Gerede
authors.forename: Aydan Ongun
authors.initials: AO
authors.lastname: Ozdemir
authors.forename: Cagdas
authors.initials: C
authors.lastname: Ozdol
authors.forename: Deniz
authors.initials: D
authors.lastname: Kumbasar
authors.forename: Cetin
authors.initials: C
authors.lastname: Erol
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001783:Blood Flow Velocity / Q000187:drug effects; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000473:pathology / Q000628:therapy*; D009336:Necrosis; D010865:Pilot Projects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D000077466:Tirofiban; D014443:Tyrosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D000077466:Tirofiban