Document Detail

Comparison of abciximab with "high-dose" tirofiban in patients undergoing percutaneous coronary intervention.
MedLine Citation:
PMID:  16014315     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The TARGET study has been criticised for sub-optimal platelet inhibition with tirofiban. We aimed to compare a high-dose bolus regimen of tirofiban (hd-tirofiban) to standard dose of abciximab for patients undergoing percutaneous coronary intervention (PCI).
METHODS: We assessed consecutive patients who received either hd-tirofiban (25 mcg/kg bolus followed by 0.15 mcg/kg/min infusion for 18 h) or standard dose abciximab. In-hospital and 6-month outcomes were obtained in all cases.
RESULTS: Over an 18-month period, 109 patients who received hd-tirofiban were compared with 110 patients who received abciximab. Both hd-tirofiban and abciximab groups had acute coronary syndromes in 86% and 80% and diabetes in 10% and 13% respectively. Most patients had coronary stent implantation (96% vs. 98%). Thrombocytopenia (platelet count< 100,000) developed in 0.9% of patients receiving hd-tirofiban and 2% of patients receiving abciximab (p = 0.566). Bleeding requiring transfusion occurred in 7.3% and 3% of patients respectively (p = 0.118). Peri-procedural troponin rise was 0.9% in patients receiving hd-tirofiban and 5.5% in patients receiving abciximab (p = 0.07). MACE (Myocardial infarction, Stroke, Revascularisation and Death) at 6 months was 23% in the hd-tirofiban group and 20% in the abciximab group (p = 0.711). The pharmaceutical costs were AUD 322 for hd-tirofiban (one ampoule) and AUD 1,350 for abciximab (3 ampoules).
CONCLUSION: There was a small increase in bleeding requiring transfusion and a lower rate of peri-procedural troponin rise in the hd-tirofiban group however, the overall 6-month MACE rates were similar in both groups. There was a considerable cost-saving with the use of hd-tirofiban. A prospective randomised trial of hd-tirofiban vs. abciximab is warranted.
Athula P Gunasekara; Darren L Walters; Con N Aroney
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2005-07-12
Journal Detail:
Title:  International journal of cardiology     Volume:  109     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-31     Completed Date:  2006-09-27     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  16-20     Citation Subset:  IM    
Cardiology Department, The Prince Charles Hospital, Chermside, Brisbane, 4032 Australia.
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MeSH Terms
Angina, Unstable / drug therapy
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / administration & dosage,  economics,  therapeutic use*
Diabetic Angiopathies / drug therapy
Immunoglobulin Fab Fragments / administration & dosage,  economics,  therapeutic use*
Middle Aged
Myocardial Infarction / drug therapy
Platelet Aggregation Inhibitors / administration & dosage,  economics,  therapeutic use*
Platelet Glycoprotein GPIIb-IIIa Complex / administration & dosage,  economics,  therapeutic use*
Retrospective Studies
Troponin / blood
Tyrosine / administration & dosage,  analogs & derivatives*,  economics,  therapeutic use
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/Troponin; 144494-65-5/tirofiban; 55520-40-6/Tyrosine; X85G7936GV/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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