title: [Short- or long-outcome of early tirofiban in ST-segment elevated acute myocardial infarction undergoing elective percutaneous coronary intervention].
abstract: OBJECTIVE
  To explore the optimal timing of tirofiban early treatment in ST-segment elevated acute myocardial infarction (STEMI) undergoing elective percutaneous coronary intervention (PCI).
  
  
  METHODS
  A total of 118 consecutive STEMI patients were enrolled in the study. They were randomly assigned to the tirofiban early treatment group with tirofiban administrated routinely at ≥ 4 hours prior to angiography or the control group with tirofiban provisional administrated during or after angiography. Thrombolysis in myocardial infarction (TIMI) flow, creatine kinase MB isoenzyme (CK-MB) levels, acute thrombus events, efficacy and safety endpoints at Day 7, Day 30, 6 months and 1 year (efficacy endpoints: death, myocardial infarction, target vessel revascularization and ischemic stroke; safety endpoints: bleeding and thrombocytopenia) were observed and compared between the two groups.
  
  
  RESULTS
  A total of 104 STEMI patients underwent elective PCI with 52 patients in each group and the baseline characteristics were balanced between the two groups. Tirofiban was administered (5.9 ± 2.9) hours earlier in the tirofiban early treatment group than the control group. No statistical difference was observed between the two groups in TIMI flow before[grade 0: 18 (34.6%) vs 19 (36.5%) , grade 3: 28 (53.8%) vs 27 (51.9%)] and after PCI[grade 3: 52 (100.0%) vs 51 (98.1%)]. No difference was shown between the two groups in CK-MB levels before PCI [(12.9 ± 5.1) U/L vs (12.0 ± 5.2) U/L, P > 0.05]; and the increase of CK-MB 12-24 hours after PCI [(1.0 ± 6.2) U/L vs (2.3 ± 8.3) U/L, P > 0.05]. The incidence of acute thrombus events was similar (7.7% vs 15.4%, P > 0.05). No statistical difference was observed between the two groups in the efficacy endpoints at Day 7 (0.0% vs 7.7%, P > 0.05), Day 30 (0.0% vs 7.8%, P > 0.05), 6 months (2.0% vs 9.8%, P > 0.05) and 1 year (2.2% vs 9.8%, P > 0.05). Similar incidence was shown in the slight bleeding (15.4% vs 5.8%, P > 0.05) and the slight thrombocytopenia (0.0% vs 1.9%, P > 0.05), while no severe to moderate bleeding or severe thrombocytopenia happened in both groups.
  
  
  CONCLUSIONS
  Tirofiban early treatment is not better than the tirofiban bailout treatment during or after PCI in STEMI patients undergoing elective PCI. Trail registration ChiCTR-TRC-10000809.
authors.forename: You
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Zhengzhou University People's Hospital, Henan Institute of Cardiovascular Epidemiology, Zhengzhou 450003, China. Email: gaocy6802@163.com.
authors.forename: Chuanyu
authors.initials: C
authors.lastname: Gao
authors.forename: Muwei
authors.initials: M
authors.lastname: Li
authors.forename: Hongzhi
authors.initials: H
authors.lastname: Liu
authors.forename: Xianpei
authors.initials: X
authors.lastname: Wang
authors.forename: Honghui
authors.initials: H
authors.lastname: Yang
authors.forename: Xianqing
authors.initials: X
authors.lastname: Wang
authors.forename: Zhongyu
authors.initials: Z
authors.lastname: Zhu
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D014443:Tyrosine; D000077466:Tirofiban