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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...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kare Publishing
2016
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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. |
format | Online Article Text |
id | pubmed-5336940 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Kare Publishing |
record_format | MEDLINE/PubMed |
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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