Key result
Upstream administration of tirofiban before PCI significantly increased spontaneous reperfusion of the infarct-related artery compared to no tirofiban (36.5% vs 17.2%; OR 2.32, 95% CI 1.25-4.31).
Why the study?
Does upstream administration of tirofiban before PCI improve spontaneous reperfusion and clinical outcomes in patients with STEMI?
Observational
Does upstream administration of tirofiban before PCI improve spontaneous reperfusion and clinical outcomes in patients with STEMI?
Upstream administration of tirofiban before PCI in STEMI patients is associated with increased spontaneous reperfusion and improved short-term MACE-free survival.
May support upstream tirofiban for reperfusion in STEMI; leaves open randomized confirmation of outcome benefit.
We assessed the effects of upstream administration of the glycoprotein IIb/IIIa inhibitor tirofiban before percutaneous coronary intervention (PCI) on spontaneous reperfusion (SR) of infarct-related artery (IRA) and the clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The incidence of SR of the IRA was significantly higher in the tirofiban group than in the no-tirofiban group (141 [36.5%] vs 21 [17.2%], P < .001). By multivariate logistic regression analysis, use of tirofiban (odds ratio 2.32, 95% confidence interval 1.25-4.31, P = .008) independently predicted the occurrence of SR. Kaplan-Meier survival analysis demonstrated that major adverse cardiovascular event-free survival was significantly higher in patients treated with tirofiban than in patients without tirofiban at 30-day (log rank = 11.65, P = .001) and 90-day follow-up (log rank = 16.79, P < .001). Upstream administration of tirofiban is significantly associated with increased SR of the IRA and favorable clinical prognosis in patients undergoing PCI for STEMI.
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Zhu et al. (2013) conducted an observational in ST-segment elevation myocardial infarction (STEMI). Upstream administration of tirofiban vs. No tirofiban was evaluated on Spontaneous reperfusion (SR) of infarct-related artery (IRA) (OR 2.32, 95% CI 1.25-4.31, p=0.008). Upstream administration of tirofiban before PCI significantly increased spontaneous reperfusion of the infarct-related artery compared to no tirofiban (36.5% vs 17.2%; OR 2.32, 95% CI 1.25-4.31).
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