Intracoronary versus intravenous high-dose bolus plus maintenance administration of tirofiban in patients undergoing primary percutaneous coronary intervention for acute ST elevation myocardial infarction

CANDEMİR B., KILIÇKAP M., Ozcan O. U., TULUNAY KAYA C., Gerede M., Ozdemir A., ...Daha Fazla

JOURNAL OF THROMBOSIS AND THROMBOLYSIS, sa.1, ss.65-72, 2012 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2012
  • Doi Numarası: 10.1007/s11239-012-0685-y
  • Dergi Adı: JOURNAL OF THROMBOSIS AND THROMBOLYSIS
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.65-72
  • Anahtar Kelimeler: Glycoprotein 2b/3a inhibitors, Coronary artery disease, Acute coronary syndrome, ST elevation myocardial infarction, PRIMARY ANGIOPLASTY, ADJUNCTIVE THERAPY, RECEPTOR OCCUPANCY, PLATELET-FUNCTION, ABCIXIMAB, EPTIFIBATIDE, REPERFUSION, RISK, METAANALYSIS, INHIBITION
  • Ankara Üniversitesi Adresli: Evet

Özet

We aimed to examine whether intracoronary high-dose bolus of tirofiban plus maintenance would result in improved clinical outcome in STEMI patients undergoing primary PCI in this pilot trial. A total of 56 patients were enrolled to receive either intracoronary high-dose bolus plus maintenance (n = 34) or intravenous high-dose bolus plus maintenance (n = 22) of tirofiban. Pre and post intervention TIMI flow grades, myocardial blush grades, peak CKMB and troponin levels, time to peak CKMB and troponin, time to 50% ST resolution and major composite adverse cardiac event rates at 30 days were recorded. Although incidence of major adverse cardiac events was not different, post intervention TIMI flow and TIMI blush grades, peak CKMB and troponin levels, and time to peak CKMB and time to peak troponin were significantly different, favoring intracoronary strategy. In conclusion, this regimen improved myocardial reperfusion and coronary flow, and reduced myocardial necrosis, but failed to improve clinical outcomes at 30 days.