| Impact of early tirofiban administration on myocardial salvage in patients with acute myocardial infarction undergoing infarct-related artery stenting. | |
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MedLine Citation:
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PMID: 16717465 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND/AIMS: The timing of GpIIb/IIIa inhibitor administration may be important in achieving early epicardial and myocardial reperfusion. We evaluated the effect of early tirofiban on myocardial salvage and cardiovascular outcome in patients with acute myocardial infarction (AMI) undergoing infarct-related artery stenting. METHODS: Patients (n = 66) with a first AMI presenting <6 h from onset of symptoms were randomized to either early administration of tirofiban in the emergency room (n = 32) or later administration in the catheterization laboratory (n = 34) (tirofiban bolus dose of 10 microg/kg, followed by 0.15 microg/kg for 24 h). The primary end-point was the degree of myocardial salvage, determined by means of serial scintigraphic studies with technetium-99m sestamibi. Thirty-day major adverse cardiac events were also assessed. RESULTS: There were no significant differences in patient characteristics or in their presentation. The mean door-to-balloon time was similar in both groups (43 +/- 12 and 53 +/- 9 min, p = 0.08). The early and late treatment groups received tirofiban 18 +/- 4 and 52 +/- 10 min after admission, respectively. Angiographic analysis revealed a higher initial frequency of TIMI grade 3 flow in the early group (31% vs. 12%, p = 0.04). Procedural success was achieved in all patients. Myocardial risk area were comparable between early and late treatment groups (35.6 +/- 12.2% vs. 39.3 +/- 14.0%, p = 0.6). Scintigraphic outcomes demonstrated a significant reduction in the final infarction size (11.8 +/- 5.2% vs. 22.4 +/- 6.2%, p = 0.01), and improvement in salvage index (0.68 +/- 0.22 vs. 0.44 +/- 0.18, p = 0.003) in favor of the early tirofiban group. The thirty-day composite end-point of death, recurrent MI or rehospitalization also favored the early group (6% early, 15% late, p = 0.06). CONCLUSION: Early tirofiban administration enhanced the degree of myocardial salvage and clinical outcome in patients with AMI undergoing infarct-related artery stenting. |
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Authors:
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Ayse Emre; Ekrem Ucer; Kemal Yesilcimen; Tuba Bilsel; Dilaver Oz; Nurten Sayar; Sait Terzi; Tamer Akbulut; Birsen Ersek |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2006-05-22 |
Journal Detail:
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Title: Cardiology Volume: 106 ISSN: 0008-6312 ISO Abbreviation: Cardiology Publication Date: 2006 |
Date Detail:
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Created Date: 2006-11-19 Completed Date: 2007-02-12 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 1266406 Medline TA: Cardiology Country: Switzerland |
Other Details:
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Languages: eng Pagination: 264-9 Citation Subset: IM |
Copyright Information:
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2006 S. Karger AG, Basel |
Affiliation:
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Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey. aysesay@superonline.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* Combined Modality Therapy Female Fibrinolytic Agents / administration & dosage* Humans Male Middle Aged Myocardial Infarction / drug therapy*, radionuclide imaging Radiopharmaceuticals / diagnostic use Salvage Therapy Stents* Technetium Tc 99m Sestamibi / diagnostic use Treatment Outcome Tyrosine / administration & dosage, analogs & derivatives* |
| Chemical | |
Reg. No./Substance:
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0/Fibrinolytic Agents; 0/Radiopharmaceuticals; 109581-73-9/Technetium Tc 99m Sestamibi; 144494-65-5/tirofiban; 55520-40-6/Tyrosine |
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