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The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI

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 infarc...

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Autores principales: Kaymaz, Cihangir, Keleş, Nurşen, Özdemir, Nihal, Tanboğa, İbrahim Halil, Demircan, Hacer C., Can, Mehmet M., Koca, Fatih, İzgi, İbrahim Akın, Özkan, Alper, Türkmen, Muhsin, Kırma, Cevat, Esen, Ali M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336940/
https://www.ncbi.nlm.nih.gov/pubmed/25868037
http://dx.doi.org/10.5152/akd.2014.5656
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author Kaymaz, Cihangir
Keleş, Nurşen
Özdemir, Nihal
Tanboğa, İbrahim Halil
Demircan, Hacer C.
Can, Mehmet M.
Koca, Fatih
İzgi, İbrahim Akın
Özkan, Alper
Türkmen, Muhsin
Kırma, Cevat
Esen, Ali M.
author_facet Kaymaz, Cihangir
Keleş, Nurşen
Özdemir, Nihal
Tanboğa, İbrahim Halil
Demircan, Hacer C.
Can, Mehmet M.
Koca, Fatih
İzgi, İbrahim Akın
Özkan, Alper
Türkmen, Muhsin
Kırma, Cevat
Esen, Ali M.
author_sort Kaymaz, Cihangir
collection PubMed
description 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 pg/kg) was followed by infusion (0.15 pg/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. CONCLUSION: 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.
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spelling pubmed-53369402017-06-28 The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI Kaymaz, Cihangir Keleş, Nurşen Özdemir, Nihal Tanboğa, İbrahim Halil Demircan, Hacer C. Can, Mehmet M. Koca, Fatih İzgi, İbrahim Akın Özkan, Alper Türkmen, Muhsin Kırma, Cevat Esen, Ali M. Anatol J Cardiol Original Investigation 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 pg/kg) was followed by infusion (0.15 pg/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. CONCLUSION: 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. Kare Publishing 2016-11 2014-12-25 /pmc/articles/PMC5336940/ /pubmed/25868037 http://dx.doi.org/10.5152/akd.2014.5656 Text en Copyright © 2015 Turkish Society of Cardiology http://creativecommons.org/licenses/by-nc-sa/4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Investigation
Kaymaz, Cihangir
Keleş, Nurşen
Özdemir, Nihal
Tanboğa, İbrahim Halil
Demircan, Hacer C.
Can, Mehmet M.
Koca, Fatih
İzgi, İbrahim Akın
Özkan, Alper
Türkmen, Muhsin
Kırma, Cevat
Esen, Ali M.
The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title_full The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title_fullStr The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title_full_unstemmed The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title_short The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI
title_sort effects of tirofiban infusion on clinical and angiographic outcomes of patients with stemi undergoing primary pci
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336940/
https://www.ncbi.nlm.nih.gov/pubmed/25868037
http://dx.doi.org/10.5152/akd.2014.5656
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