Key result
Tirofiban combined with heparin or dalteparin significantly reduced the incidence of major adverse cardiac events at 6 months compared to heparin or dalteparin alone in patients with acute coronary syndrome undergoing revascularization (p=0.02).
Why the study?
Does tirofiban combined with heparin or dalteparin reduce major adverse cardiac events in patients with acute coronary syndrome?
RCT (n=160)
randomly assigned
No
Does tirofiban combined with heparin or dalteparin reduce major adverse cardiac events in patients with acute coronary syndrome?
p-value: p=0.02
Tirofiban plus heparin or dalteparin may benefit ACS management; leaves open need for confirmatory RCTs.
BACKGROUND: Platelet activation and aggregation with resultant arterial thrombus formation play a pivotal role in the pathophysiology of acute coronary syndrome (ACS). In the present study the efficacy of tirofiban, a specific inhibitor of the platelet glycoprotein IIb/IIIa receptor, combined with heparin or low-molecular-weight heparin (dalteparin), was evaluated for the management of ACS. METHODS AND RESULTS: One hundred and sixty patients (60.9+/-11.1 years, 104 male) with unstable angina or non-ST elevation myocardial infarction and who had ST-T changes and elevated troponin were randomly assigned to 4 groups: group I (n=40: heparin alone), group II (n=40: dalteparin alone), group III (n=40: tirofiban + heparin) and group IV (n=40: tirofiban + dalteparin). The occurrence of major adverse cardiac events (MACE) was compared prospectively during a 6-month clinical follow-up. Percutaneous coronary intervention or coronary artery bypass graft was performed in 32 cases in group I, 29 in group II, 28 in group III and 31 in group IV (p=0.72). Minor bleeding complication developed in 2 patients (5.0%) in group I, 2 (5.0%) in group II, 4 (10.0%) in group III and 3 (7.5%) in group IV (p=0.78). During the follow-up MACE occurred in 10 patients (31.3%) in group I, 9 (31.0%) in group II, 4 (14.3%) in group III and 4 (12.9%) in group IV (p=0.02: Group I and II vs Group III and IV). CONCLUSIONS: Tirofiban combined with dalteparin was associated with relatively more bleeding complications in the short term, but was effective in reducing the incidence of MACE during long-term clinical follow-up in patients with ACS.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2005) conducted an RCT in Acute Coronary Syndrome (n=160). Tirofiban combined with heparin or dalteparin vs. Heparin or dalteparin alone was evaluated on Major adverse cardiac events (MACE) at 6 months (p=0.02). Tirofiban combined with heparin or dalteparin significantly reduced the incidence of major adverse cardiac events at 6 months compared to heparin or dalteparin alone in patients with acute coronary syndrome undergoing revascularization (p=0.02).