title: Effects of upstream administration of tirofiban before percutaneous coronary intervention on spontaneous reperfusion and clinical outcomes in acute ST-segment elevation myocardial infarction.
abstract: We assessed the effects of upstream administration of the glycoprotein IIb/IIIa inhibitor tirofiban before percutaneous coronary intervention (PCI) on spontaneous reperfusion (SR) of infarct-related artery (IRA) and the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The incidence of SR of the IRA was significantly higher in the tirofiban group than in the no-tirofiban group (141 [36.5%] vs 21 [17.2%], P < .001). By multivariate logistic regression analysis, use of tirofiban (odds ratio 2.32, 95% confidence interval 1.25-4.31, P = .008) independently predicted the occurrence of SR. Kaplan-Meier survival analysis demonstrated that major adverse cardiovascular event-free survival was significantly higher in patients treated with tirofiban than in patients without tirofiban at 30-day (log rank = 11.65, P = .001) and 90-day follow-up (log rank = 16.79, P < .001). Upstream administration of tirofiban is significantly associated with increased SR of the IRA and favorable clinical prognosis in patients undergoing PCI for STEMI.
authors: Department of Cardiology, Third People's Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Jianbing
authors: J
authors: Zhu
authors: Department of Cardiology, Third People's Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Tiantian
authors: T
authors: Zhang
authors: Department of Cardiology, Third People's Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China.
authors: Qianqian
authors: Q
authors: Xie
authors: Department of Cardiology, Third People's Hospital Affiliated to School of Medicine, Shanghai Jiaotong University, Shanghai, China jfzhang_dr@163.com.
authors: Junfeng
authors: J
authors: Zhang
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003326:Coronary Circulation / Q000187:drug effects*; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015425:Myocardial Reperfusion / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D000077466:Tirofiban
keywords: ST-segment elevation myocardial infarction; clinical outcomes; percutaneous coronary intervention; spontaneous reperfusion; tirofiban