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Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial

BACKGROUND: We conducted a randomized controlled trial to investigate whether an additional platelet inhibition with tirofiban would reduce the extent of myocardial damage and prevent periprocedural myonecrosis in patients with Non-ST-elevation acute coronary syndrome (NSTE-ACS) with a high residual...

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Autores principales: Lee, Wonjae, Suh, Jung-Won, Park, Jin Joo, Yoon, Chang-Hwan, Cho, Young-Seok, Youn, Tae-Jin, Chae, In-Ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198526/
https://www.ncbi.nlm.nih.gov/pubmed/30348101
http://dx.doi.org/10.1186/s12872-018-0938-6
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author Lee, Wonjae
Suh, Jung-Won
Park, Jin Joo
Yoon, Chang-Hwan
Cho, Young-Seok
Youn, Tae-Jin
Chae, In-Ho
author_facet Lee, Wonjae
Suh, Jung-Won
Park, Jin Joo
Yoon, Chang-Hwan
Cho, Young-Seok
Youn, Tae-Jin
Chae, In-Ho
author_sort Lee, Wonjae
collection PubMed
description BACKGROUND: We conducted a randomized controlled trial to investigate whether an additional platelet inhibition with tirofiban would reduce the extent of myocardial damage and prevent periprocedural myonecrosis in patients with Non-ST-elevation acute coronary syndrome (NSTE-ACS) with a high residual platelet activity (HPR). METHODS: Patients with an HPR, defined as P(2)Y(12) reaction unit (PRU) > 230, were randomly assigned to group A (tirofiban treatment, n = 30) or C1 (n = 30) and patients without an HPR to C2 (n = 78). Periprocedural myocardial damage was assessed using the area under the curve (AUC) of serial cardiac enzyme levels from the time of the procedure to post-36 h. Periprocedural myonecrosis incidence was evaluated. RESULTS: The troponin I AUC was not different between the groups (197.2 [41.5395.7], 37.9 [8.9313.9], 121.3 [43.7481.8] h∙ng/mL; p = 0.088). The results did not change when the baseline levels were adjusted (365.3 [279.5, 451.1], 293.0 [207.1, 379.0], and 298.0 [244.7, 351.3] h∙ng/mL; p = 0.487). The rate of periprocedural myonecrosis was also not different between the groups (53.0% vs. 50.0% vs. 33.3%, p = 0.092). The CK-MB isoenzyme analysis showed similar results. No difference in complications was noted. CONCLUSION: Additional tirofiban administration was not beneficial to patients with NSTE-ACS even with an HPR. TRIAL REGISTRATION: Clinical trial no. NCT03114995, registered 11 April, 2017, retrospectively. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12872-018-0938-6) contains supplementary material, which is available to authorized users.
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spelling pubmed-61985262018-10-31 Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial Lee, Wonjae Suh, Jung-Won Park, Jin Joo Yoon, Chang-Hwan Cho, Young-Seok Youn, Tae-Jin Chae, In-Ho BMC Cardiovasc Disord Research Article BACKGROUND: We conducted a randomized controlled trial to investigate whether an additional platelet inhibition with tirofiban would reduce the extent of myocardial damage and prevent periprocedural myonecrosis in patients with Non-ST-elevation acute coronary syndrome (NSTE-ACS) with a high residual platelet activity (HPR). METHODS: Patients with an HPR, defined as P(2)Y(12) reaction unit (PRU) > 230, were randomly assigned to group A (tirofiban treatment, n = 30) or C1 (n = 30) and patients without an HPR to C2 (n = 78). Periprocedural myocardial damage was assessed using the area under the curve (AUC) of serial cardiac enzyme levels from the time of the procedure to post-36 h. Periprocedural myonecrosis incidence was evaluated. RESULTS: The troponin I AUC was not different between the groups (197.2 [41.5395.7], 37.9 [8.9313.9], 121.3 [43.7481.8] h∙ng/mL; p = 0.088). The results did not change when the baseline levels were adjusted (365.3 [279.5, 451.1], 293.0 [207.1, 379.0], and 298.0 [244.7, 351.3] h∙ng/mL; p = 0.487). The rate of periprocedural myonecrosis was also not different between the groups (53.0% vs. 50.0% vs. 33.3%, p = 0.092). The CK-MB isoenzyme analysis showed similar results. No difference in complications was noted. CONCLUSION: Additional tirofiban administration was not beneficial to patients with NSTE-ACS even with an HPR. TRIAL REGISTRATION: Clinical trial no. NCT03114995, registered 11 April, 2017, retrospectively. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12872-018-0938-6) contains supplementary material, which is available to authorized users. BioMed Central 2018-10-22 /pmc/articles/PMC6198526/ /pubmed/30348101 http://dx.doi.org/10.1186/s12872-018-0938-6 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Lee, Wonjae
Suh, Jung-Won
Park, Jin Joo
Yoon, Chang-Hwan
Cho, Young-Seok
Youn, Tae-Jin
Chae, In-Ho
Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title_full Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title_fullStr Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title_full_unstemmed Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title_short Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
title_sort effect of tailored use of tirofiban in patients with non-st-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6198526/
https://www.ncbi.nlm.nih.gov/pubmed/30348101
http://dx.doi.org/10.1186/s12872-018-0938-6
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