title: The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI.
abstract: OBJECTIVE
  The present study was designed to determine the effects of tirofiban (Tiro) infusion on angiographic measures, ST-segment resolution, and clinical outcomes in patients with STEMI undergoing PCI. Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), while the most effective timing of administration is still under investigation.
  
  
  METHODS
  A total of 1242 patients (83.0% males, mean (standard deviation; SD) age: 54.7 (10.9) years) with STEMI who underwent primary PCI were included in this retrospective non-randomized study in four groups, composed of no tirofiban infusion [Tiro (-); n=248], tirofiban infusion before PCI (pre-Tiro; n=720), tirofiban infusion during PCI (peri-Tiro; n=50), and tirofiban infusion after PCI (post-Tiro; n=224). In all Tiro (+) patients, bolus administration of Tiro (10 µg/kg) was followed by infusion (0.15 µg/kg/min) for a mean (SD) duration of 22.4±6.8 hours.
  
  
  RESULTS
  The pre-PCI Tiro group was associated with the highest percentage of patients with TIMI 3 flow (99.4%; p<0.001), the lowest corrected TIMI frame count [21(18-23.4); p<0.001], the highest percentage of patients with >75% ST-segment resolution (78.1%; p<0.001), and the lowest rate of in-hospital sudden cardiac death and in-hospital all-cause mortality (3.2%, p<0.05, 3.3%, p=0.01). Major bleeding was reported in 18 (1.8%) patients who received tirofiban.
  
  
  CONCLUSIONS
  Use of standard-dose bolus tirofiban in addition to aspirin, high-dose clopidogrel, and unfractionated heparin prior to primary PCI significantly improves myocardial reperfusion, ST-segment resolution, in-hospital mortality rate, and in-hospital sudden cardiac death in patients with STEMI with no increased risk of major bleeding.
authors: Department of Cardiology, Kartal Koşuyolu Yüksek İhtisas Training and Research Hospital; İstanbul-Turkey. cihangirkaymaz2002@yahoo.com.
authors: Cihangir
authors: C
authors: Kaymaz
authors: Nurşen
authors: N
authors: Keleş
authors: Nihal
authors: N
authors: Özdemir
authors: İbrahim Halil
authors: İH
authors: Tanboğa
authors: Hacer C
authors: HC
authors: Demircan
authors: Mehmet M
authors: MM
authors: Can
authors: Fatih
authors: F
authors: Koca
authors: İbrahim Akın
authors: İA
authors: İzgi
authors: Alper
authors: A
authors: Özkan
authors: Muhsin
authors: M
authors: Türkmen
authors: Cevat
authors: C
authors: Kırma
authors: Ali M
authors: AM
authors: Esen
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D014443:Tyrosine; D000077466:Tirofiban