title: Impact of selective infarct-related artery infusion of tirofiban on myocardial reperfusion and bleeding complications in patients with acute myocardial infarction: the SUIT-AMI trial.
abstract: BACKGROUND
  It is unclear whether selective infarct-related artery (sIRA) administration of glycoprotein IIb/IIIa receptor inhibitors (GPI) may further improve myocardial reperfusion without increasing bleeding in patients with ST-elevation myocardial infarction (STEMI). The aim of this study was to compare the impacts of sIRA infusion with conventional intracoronary (IC) administration of GPI tirofiban on myocardial reperfusion and clinical prognosis in STEMI patients.
  
  
  METHODS
  A total of 203 consecutive STEMI patients within 12 hours of symptom onset were randomly assigned to receive tirofiban (10 μg/kg body weight) through aspiration catheter (n = 107) or guiding catheter (n = 96) after thrombus aspiration, and following 12 hours of intravenous infusion (0.1 μg/kg/min). The primary endpoint was the corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (CTFC) after the procedure. The secondary endpoint was major adverse cardiac events at 30 days and 6 months. The safety endpoint was in-hospital bleeding, defined according to the TIMI bleeding classification.
  
  
  RESULTS
  Similar primary endpoints (CTFC of 28 ± 17 vs 27 ± 15; P=.841) were observed in the sIRA and conventional IC administration groups, respectively. The incidence of major adverse cardiac events (6.5% vs 5.2% at 30 days [P=.688] and 8.4% vs 7.3% at 6 months [P=.762]) and in-hospital major or minor bleeding (9.3% vs 8.3%; P=.800) were comparable in both groups.
  
  
  CONCLUSIONS
  After thrombus aspiration, sIRA infusion of tirofiban does not improve myocardial reperfusion assessed by CTFC, as well as ischemic or bleeding events in this study.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.forename: Peng
authors.initials: P
authors.lastname: Zhou
authors.forename: Hongbing
authors.initials: H
authors.lastname: Yan
authors.forename: Hanjun
authors.initials: H
authors.lastname: Zhao
authors.forename: Li
authors.initials: L
authors.lastname: Song
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.forename: Bo
authors.initials: B
authors.lastname: Zhao
authors.forename: Yunpeng
authors.initials: Y
authors.lastname: Chi
authors.forename: Shaoping
authors.initials: S
authors.lastname: Wang
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology*; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D014443:Tyrosine; D000077466:Tirofiban