In-hospital outcomes in patients of STEMI (STsegment elevation MI) undergoing PPCI (Primary Percutaneous Coronary Intervention) with Intra Coronary Tirofiban vs Intravenous Tirofiban.

Q: What are the key findings of this study?

Intracoronary tirofiban significantly increased TIMI grade 3 flow (96.2% vs 80.0%, p<0.001) and reduced in-hospital MACE (11.4% vs 27.6%, p=0.003) compared to intravenous tirofiban during PPCI.

Q: What is the clinical evidence from this study?

Population: ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) (n=210). Intervention: Intracoronary tirofiban vs. Intravenous tirofiban (10 µg/kg IV bolus over 1-3 minutes followed by 0.15 µg/kg/min IV infusion over 24 hours). Primary outcome: TIMI grade 3 flow (p=<0.001).

Q: What does this research mean for the field?

Intracoronary tirofiban improves coronary and myocardial perfusion and reduces in-hospital major adverse cardiac events compared to intravenous tirofiban in STEMI patients undergoing primary PCI. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

Q: What question did this study set out to answer?

To compare in-hospital outcomes, including coronary and myocardial perfusion and major adverse cardiac events, between intracoronary and intravenous tirofiban administration in STEMI patients undergoing primary PCI.

Waseem Ahmad; Shahid Abbas; Kubra Anjum

doi:10.29309/tpmj/2026.33.10.10624

October 2, 2026The Professional Medical JournalOpen Access

In-hospital outcomes in patients of STEMI (STsegment elevation MI) undergoing PPCI (Primary Percutaneous Coronary Intervention) with Intra Coronary Tirofiban vs Intravenous Tirofiban.

View Full Paper

Ask AI

Bookmark

Share

Key result

Intracoronary tirofiban linked to ~16-point higher TIMI 3 flow and fewer in-hospital MACE vs intravenous administration.

P<0.001
n=210

Why the study?

This study aimed to compare the frequency of in-hospital outcomes between intracoronary tirofiban and intravenous tirofiban in patients with acute STEMI undergoing primary PCI.

Does intracoronary tirofiban bolus followed by intravenous infusion improve coronary/myocardial perfusion (TIMI grade 3 flow, TMP grade 2–3 flow) and reduce in-hospital MACE compared to intravenous tirofiban alone in STEMI patients undergoing primary PCI?

Key Points

To compare in-hospital outcomes, including coronary and myocardial perfusion and major adverse cardiac events, between intracoronary and intravenous tirofiban administration in STEMI patients undergoing primary PCI.
Non-randomized controlled trial conducted at Faisalabad Institute of Cardiology from November 2025 to April 2026, enrolling 210 patients aged 20–65 years with STEMI undergoing primary PCI.
Patients were equally divided into intracoronary tirofiban (Group A, n=105) and intravenous tirofiban (Group B, n=105) cohorts.
Outcomes assessed during the hospital stay included TIMI grade 3 flow, TMP grade 2–3 flow, and major adverse cardiac events (MACE).
Intracoronary tirofiban achieved higher rates of TIMI grade 3 flow (96.2% [101/105] vs 80.0% [84/105], p<0.001) and TMP grade 2–3 flow (89.5% [94/105] vs 67.6% [71/105], p<0.001) compared to intravenous administration.
The incidence of in-hospital major adverse cardiac events was significantly lower in the intracoronary group than in the intravenous group (11.4% [12/105] vs 27.6% [29/105], p=0.003).

Structured PICO

Does intracoronary tirofiban bolus followed by intravenous infusion improve coronary/myocardial perfusion (TIMI grade 3 flow, TMP grade 2–3 flow) and reduce in-hospital MACE compared to intravenous tirofiban alone in STEMI patients undergoing primary PCI?

P

Population

210 patients aged 20-65 years (35.7% female) in Pakistan with acute STEMI undergoing primary PCI without cardiogenic shock or prior ischemic heart disease, followed until hospital discharge.

I

Intervention

Intracoronary tirofiban bolus (10 µg/kg infused over 13 minutes) followed by intravenous tirofiban maintenance infusion (0.15 µg/kg/min over 24 hours) during primary PCI (n=105).

C

Comparator

Intravenous tirofiban bolus (10 µg/kg infused during 1–3 minutes) followed by intravenous tirofiban maintenance infusion (0.15 µg/kg/min over 24 hours) during primary PCI (n=105).

O

Outcome

In-hospital outcomes including Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow, TIMI Myocardial Perfusion (TMP) grade 2–3 flow, and major adverse cardiac events (MACE: composite of post-angina, cardiac death, rehospitalization, reinfarction, repeat revascularization, and heart failure Killip class II to IV) measured clinically until hospital discharge.composite

Main Result

Absolute Event Rate: 96.2% vs 80%

p-value: p=<0.001

In STEMI patients undergoing primary PCI, intracoronary bolus administration of tirofiban significantly improved epicardial (TIMI 3) and microvascular (TMP 2–3) perfusion and reduced in-hospital MACE compared to an intravenous bolus route.

Limitations

Single-center study
Non-randomized design limiting generalizability
Sample size may be inadequate to detect infrequent outcomes like death or stroke
Lack of long-term follow-up
Lack of sophisticated imaging modalities
Single-center study limiting generalizability
Non-randomized design
Sample size may be inadequate to identify infrequent outcomes like death or stroke
No use of sophisticated imaging modalities

Implication

Supports intracoronary over intravenous tirofiban in STEMI PPCI; extends evidence on glycoprotein IIb/IIIa inhibitor administration route.

Abstract

Objective: To compare the frequency of in hospital outcomes in patients of acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with intracoronary Tirofiban vs intravenous Tirofiban. Study Design: Non-randomized Controlled Trial. Setting: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad. Period: Six months Nov 2025 to April 2026. Methods: Included 210 patients aged 20–65 years with STEMI undergoing primary PCI. Patients were equally divided into intracoronary (Group A) and intravenous (Group B) tirofiban groups. Outcomes assessed included Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow, TMP grade 2–3 flow, and MACE during hospital stay. Results: Intracoronary tirofiban resulted in significantly higher TIMI grade 3 flow (96.2% vs 80.0%, p<0.001) and TMP grade 2–3 flow (89.5% vs 67.6%, p<0.001) compared to intravenous administration. The incidence of MACE was significantly lower in the intracoronary group (11.4% vs 27.6%, p=0.003). Conclusion: Intracoronary administration of tirofiban was superior to intravenous administration route showing more improved coronary and myocardial perfusion and reduced in-hospital MACE in STEMI patients undergoing primary PCI.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Ahmad et al. (2026) studied ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) (n=210). Intracoronary tirofiban vs. Intravenous tirofiban (10 µg/kg IV bolus over 1-3 minutes followed by 0.15 µg/kg/min IV infusion over 24 hours) was evaluated on TIMI grade 3 flow (p=<0.001). Intracoronary tirofiban significantly increased TIMI grade 3 flow (96.2% vs 80.0%, p<0.001) and reduced in-hospital MACE (11.4% vs 27.6%, p=0.003) compared to intravenous tirofiban during PPCI.

synapsesocial.com/papers/6ae28e0ecbadf70daf6c4006 https://doi.org/10.29309/tpmj/2026.33.10.10624

View Full Paper

Ask AI

Bookmark

Share

In-hospital outcomes in patients of STEMI (STsegment elevation MI) undergoing PPCI (Primary Percutaneous Coronary Intervention) with Intra Coronary Tirofiban vs Intravenous Tirofiban.

Key Points

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

In-hospital outcomes in patients of STEMI (STsegment elevation MI) undergoing PPCI (Primary Percutaneous Coronary Intervention) with Intra Coronary Tirofiban vs Intravenous Tirofiban.

Key Points

Structured PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading