Document Detail

Prehospital high-dose tirofiban in patients undergoing primary percutaneous intervention. The AGIR-2 study.
MedLine Citation:
PMID:  20619238     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Compared with administration in the catheterization laboratory, early treatment with glycoprotein IIb/IIIa inhibitors provides benefits to patients with ST-segment elevation myocardial infarction who undergo primary percutaneous intervention. Whether this benefit is maintained on top of a 600 mg loading dose of clopidogrel is unknown.
METHODS: In a multicentre, controlled, randomized study, 320 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention received a high-dose bolus of tirofiban given either in the ambulance (prehospital group) or in the catheterization laboratory. The primary endpoint was a TIMI flow grade 2-3 of the infarct-related vessel at initial angiography. Secondary endpoints included ST-segment resolution 1h after percutaneous coronary intervention and peak serum troponin I concentration.
RESULTS: Tirofiban was administered 48 (95% confidence interval 21.4-75.0) min earlier in the prehospital group. At initial angiography, the combined incidence of TIMI 2-3 flow was 39.7% in the catheterization-laboratory group and 44.2% in the prehospital group (p=0.45). No difference was found on postpercutaneous intervention angiography or peak troponin concentration. Complete ST-segment resolution 60 min after the start of intervention was 55.4% in the catheterization-laboratory group and 52.6% in the prehospital group (p=0.32).
CONCLUSION: Prehospital initiation of high-dose bolus tirofiban did not improve significantly initial TIMI 2 or 3 flow of the infarct-related artery or complete ST-segment resolution after coronary intervention compared with initiation of tirofiban in the catheterization laboratory (NCT00538317).
Carlos El Khoury; Pierre-Yves Dubien; Catherine Mercier; Loic Belle; Guilaume Debaty; Olivier Capel; Thibault Perret; Dominique Savary; Patrice Serre; Eric Bonnefoy;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-06-17
Journal Detail:
Title:  Archives of cardiovascular diseases     Volume:  103     ISSN:  1875-2128     ISO Abbreviation:  Arch Cardiovasc Dis     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-07-12     Completed Date:  2010-10-15     Revised Date:  2011-04-25    
Medline Journal Info:
Nlm Unique ID:  101465655     Medline TA:  Arch Cardiovasc Dis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  285-92     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Masson SAS. All rights reserved.
RESCUE Network, Hussel Hospital, Vienne, France.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Biological Markers / blood
Coronary Angiography
Coronary Circulation
Creatine Kinase / blood
Drug Administration Schedule
Drug Therapy, Combination
Emergency Medical Services*
Myocardial Infarction / blood,  drug therapy,  physiopathology,  therapy*
Platelet Aggregation Inhibitors / administration & dosage*,  adverse effects
Ticlopidine / administration & dosage,  analogs & derivatives
Time Factors
Treatment Outcome
Troponin I / blood
Tyrosine / administration & dosage,  adverse effects,  analogs & derivatives*
Reg. No./Substance:
0/Biological Markers; 0/Platelet Aggregation Inhibitors; 0/Troponin I; 144494-65-5/tirofiban; 55142-85-3/Ticlopidine; 55520-40-6/Tyrosine; 90055-48-4/clopidogrel; EC Kinase
C ElKhoury / ; L Belle / ; R Maupoint / ; M Wahiche / ; K Echahed / ; G Debaty / ; P Y Dubien / ; D Savary / ; G Rioufol / ; C Besnard / ; T Perret / ; D Champagnac / ; J P Claudel / ; A Hepp / ; P Chapon / ; L Belle / ; G Vanzetto / ; C Guenot / ; P Bourlard / ; C Robin / ; Y Mann / ; D Savary / ; O Florent / ; O Cognet / ; P Serre / ; J F Rodriguez / ; F Guillaumee / ; O Capel / ; P Y Dubien / ; P Fuster / ; J S David / ; P Genevey / ; B Cheval / ; G Debaty / ; C Busseuil / ; F Pajot / ; M Wahiche / ; R Brilland / ; K Echahed / ; O Matas / ; J F Bec / ; T Guillemard / ; M Boyer / ; C Escallier / ; E Bonnefoy / ; C Elkhoury / ; N Eydoux / ; A Peiretti / ; C Mercier / ; A Bissery / ; R Ecochard / ; V Plattner /

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