Key result
A 12-hour postprocedural tirofiban infusion was associated with similar rates of repeated nonfatal ACS and/or stent thrombosis at 6 months compared to a 24-hour infusion (27.0% vs 24.4%; OR 1.02).
Why the study?
Does a 12-hour tirofiban infusion compared to a 24-hour infusion improve safety and efficacy in STEMI patients undergoing primary PCI?
Cohort (n=349)
Does a 12-hour tirofiban infusion compared to a 24-hour infusion improve safety and efficacy in STEMI patients undergoing primary PCI?
Odds Ratio: 1.02 (95% CI 0.42–2.48)
Absolute Event Rate: 27% vs 24.4%
p-value: p=0.598
A 12-hour postprocedural tirofiban infusion appears as safe and effective as a 24-hour infusion in STEMI patients undergoing primary PCI, potentially allowing for shorter infusion times.
May support shorter tirofiban infusions post-PCI in STEMI; hypothesis-generating and requires RCTs before practice change.
AIM: We aimed to investigate the 6-month efficacy and safety of postprocedural 12-hour tirofiban administration versus 24-hour tirofiban administration in patients with ST-segment elevated myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). METHODS: This retrospective study enrolled 349 patients with STEMI who underwent primary PCI. Following the administration of bolus tirofiban after primary PCI, those receiving a 12-hour tirofiban infusion as the maintenance dose were classified as group 1 (n = 123) while those receiving a 24-hour infusion were classified as group 2 (n = 226). In-hospital and 6-month major adverse cardiac events were recorded. RESULTS: There were no statistically significant differences between the 2 groups regarding in-hospital efficacy (in-hospital death: 4.4% vs 5.7%, P = .600 and stent thrombosis 1.8% vs 1.6%, P = .921) and in-hospital safety (2.6% vs 1.6% for major bleeding and 5.3% vs 4.1% for minor bleeding, P = .562). During the 6-month follow-up period, the incidence of the recurrent revascularization (16.1% vs 15.5%, odds ratio [OR] = 1.05 [0.47-3.67]), the repeated nonfatal acute coronary syndrome and/or stent thrombosis (27% vs 24.4%, P = .598, OR = 1.02 [0.42-2.48]), and the cardiovascular deaths (6.6% vs 6.5%, P = .943, OR = 1.03 [0.43-2.43]) were comparable between group 1 and group 2. CONCLUSION: Our study revealed that 12-hour tirofiban administration versus 24-hour tirofiban administration in STEMI who underwent primary PCI was similar with respect to in-hospital efficacy and safety and major adverse cardiac events during 6-month follow-up.
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Topçu et al. (2014) conducted a cohort in ST-segment elevated myocardial infarction (STEMI) (n=349). 12-hour tirofiban infusion vs. 24-hour tirofiban infusion was evaluated on repeated nonfatal acute coronary syndrome and/or stent thrombosis at 6 months (OR 1.02, 95% CI 0.42-2.48, p=0.598). A 12-hour postprocedural tirofiban infusion was associated with similar rates of repeated nonfatal ACS and/or stent thrombosis at 6 months compared to a 24-hour infusion (27.0% vs 24.4%; OR 1.02).
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