Abstract | BACKGROUND: METHODS: 100 STEMI patients were randomized according to a 2 × 2 factorial design into 1 of the 4 groups: standard PCI, PCI with initial thrombus aspiration (IT), PCI with tirofiban infusion (TI), and PCI with both treatments (IT+TI). RESULTS: The myocardial blush grade (MBG) 3 was achieved in 30.4%, 45.8%, 56% and 78.6% in the 4 groups respectively. More frequent MBG 3 (p=0.015) and complete (>70%) ST-segment resolution (STR, 67.9% vs. 41.7%, p=0.058) were observed in IT ± TI group compared with IT group. If actuarial analysis was done after reassigning the 2 TI patients who crossed over to IT+TI, the difference between IT+TI and IT groups became more significant (MBG 3 rates: 76.7% vs. 45.8%, p=0.009; complete STR rates: 70% vs. 41.7%, p=0.036). Infusion of tirofiban resulted in improved MBG and STR (p=0.003 and 0.037, respectively). Thrombus aspiration resulted in improved MBG only (p=0.048) but not in STR. 6-month MACE (death, reinfarction, target lesion revascularization and stroke) was similar among groups (p=0.725). CONCLUSIONS:
Tirofiban may augment thrombus aspiration therapy on myocardial reperfusion in primary PCI. The benefit of thrombus aspiration treatment without tirofiban might be less significant, especially on resolution of ST-segment elevation.
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Authors | Chung-Pin Liu, Mao-Shin Lin, Yu-Wei Chiu, Jen-Kuang Lee, Chih-Neng Hsu, Chi-Shen Hung, Hsien-Li Kao |
Journal | International journal of cardiology
(Int J Cardiol)
Vol. 156
Issue 2
Pg. 174-9
(Apr 19 2012)
ISSN: 1874-1754 [Electronic] Netherlands |
PMID | 21131072
(Publication Type: Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial)
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Copyright | Copyright © 2010 Elsevier Ireland Ltd. All rights reserved. |
Chemical References |
- Platelet Glycoprotein GPIIb-IIIa Complex
- Tyrosine
- Tirofiban
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Topics |
- Adult
- Aged
- Combined Modality Therapy
(methods)
- Coronary Thrombosis
(drug therapy, metabolism, surgery)
- Cross-Sectional Studies
- Female
- Humans
- Male
- Middle Aged
- Platelet Glycoprotein GPIIb-IIIa Complex
(antagonists & inhibitors, metabolism)
- Prospective Studies
- Suction
- Tirofiban
- Treatment Outcome
- Tyrosine
(analogs & derivatives, pharmacology, therapeutic use)
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