The short-term outcomes of tirofiban use in primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction (STEMI)
Keywords:
tirofiban, different dose, percutaneous coronary intervention, myocardial infarctionAbstract
Introduction: When patients suffering from acute ST-elevation myocardial infarction (STEMI) undergo for percutaneous coronary intervention, tirofiban is mostly prescribed. Objective: In this study, patients undergoing for primary percutaneous coronary intervention for ST-segment elevation myocardial infarction were evaluated to determine the impact of a high bolus dose (HBD) of tirofiban on clinical outcomes. Methods: This study included 272 acute STEMI patients aged less than 79 years, admitted to the Hayatabad Medical Complex hospital, Peshawar from April 2021 to February 2022. According to the random number table, these patients were divided into four groups: the control group (n= 65), low-dose group (n=69), medium-dose group (n=71) and high-dose group (n=67). Results: After percutaneous coronary intervention, the high-dose group experienced higher rates of corrected TIMI frame count (CTFC), Thrombolysis In Myocardial Infarction (TIMI) grade 3, and total frequency of ST-segment resolution greater than 50% than the other 3 groups while compared to the low- dose group as well as control group, the CTFC were greater in the medium dose group. Furthermore, the LVEF of the medium-dose group was much better than that of the low-dose group. Compared to other groups, the left ventricular end-diastolic and end-systolic dimensions of the high-dose group remained suggestively elevated.
Downloads
References
Agarwal SK, Agarwal S: Role of intracoronary fibrinolytic therapy in contemporary PCI practice . Cardiovasc Revasc Med. 2019, 20:1165-71.
Ahmed N, Carberry J, Teng V, et al.: Risk assessment in patients with an acute ST-elevation myocardial infarction. J Comp Eff Res. 2016, 5:581-93.
Boden WE, Eagle K, Granger CB: Reperfusion strategies in acute ST-segment elevation myocardial infarction: a comprehensive review of contemporary management options. J Am Coll Cardiol. 2007, 50:917- 929.
Chen GX, Wang HN, Zou JL, Yuan XX: Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI. World Journal of Emergency Medicine. 2020, 11:157.
De Luca G, Dirksen MT, Spaulding C, et al.: Meta-analysis comparing efficacy and safety of first generation drug-eluting stents to bare-metal stents in patients with diabetes mellitus undergoing primary percutaneous coronary intervention. Am J Cardiol. 2013, 111:1295-1304.
De Winter RJ: Anticoagulation and antiplatelet therapy in acute coronary syndromes: choosing between the Scylla of bleeding and the Charybdis of ischaemic events. Neth Heart J. 2018, 26:287-8.
Dongxing M., Huiliang L., Hongying Y., et al.: Effects of Intracoronary Tirofiban Injection on Myocardial Perfusion and Near-Future Cardiac Function in STEMI. Patients in Emergency Percutaneous Coronary Artery Intervention, J. Chinese General Practice. 2010, 5:476-478.
Erdim R, Erciyes D, G€ormez S, et al.: Comparison of intracoronary versus intravenous administration of Tirofiban in primary percutaneous coronary intervention. Anadolu Kardiyol Derg. 2010, 10:340-345.
Fabris E, Kilic S, Schellings DAAM, et al.: Long-term mortality and prehospital tirofiban treatment in patients with ST elevation myocardial infarction. Heart. 2017, 103:1515-20.
Gao R, Wang J, Zhang S, et al.: The value of combining plasma D-dimer and endothelin-1levels to predict no-reflow after percutaneous coronary intervention of ST-segment elevation in acute myocardial infarction patients with a type 2 diabetes mellitus history. Med Sci Monit. 2018, 24:3549-56.
Gershlick AH, Banning AP, Myat A, et al.: Reperfusion therapy for STEMI: is there still a role for thrombolysis in the era of primary percutaneous coronary intervention?. The Lancet. 2013, 17;382:624-32.
Hermanides RS, Kilic S, van’t Hof AWJ: Optimal pharmacological therapy in ST-elevation myocardial infarction-a review: a review of antithrombotic therapies in STEMI. Neth Heart J. 2018, 26:296-310.
Karathanos A, Lin Y, Dannenberg L, et al.: Routine glycoprotein IIb/IIIa inhibitor therapy in ST-segment elevation myocardial infarction: a metaanalysis. Can J Cardiol. 2019, 35:1576-88.
Lang SH, Manning N, Armstrong N, et al.: Treatment with Tirofiban for acute coronary syndrome (ACS): a systematic review and network analysis. Curr Med Res Opin. 2012, 28:351-370.
Lei Z, Xiaoming Z, Yan H, et al.: Analysis of the Best Timing for Applying Tirofiban in PCI Operation for the Patients with ST Segment Elevation Myocardial Infarction. Open Medicine. 2015, 10. https://doi.org/10.1515/med-2015-0065
Liu Y, Liu H, Hao Z, et al.: Efficacy and safety of different doses of tirofiban combined with ticagrelor on diabetic patients withAMI receiving in emergency percutaneous coronary intervention (PCI). Int J Clin Exp Med. 2015, 8:11360-9.
Niu XW, Zhang JJ, Bai M, et al.: Combined thrombectomy and intracoronary administration of glycoprotein IIb/IIIa inhibitors improves myocardial reperfusion in patients undergoing primary percutaneous coronary intervention: a meta-analysis. J Geriatr Cardiol. 2017, 14:614-23.
Ren LH, Peng JJ, Ye HM, Wang ZY, Chen C: High-dose Tirofiban in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Chin Med J. 2012, 92:1981- 1983.
Tu Y, Hu L, Yang C, et al.: Optimal antithrombotic therapy for patients with STEMI undergoing PCI at high risk of bleeding. Curr Atheroscler Rep. 2019, 21:22-30.
Ulus T, S¸enol U, Tahmazov S, et al.: High-dose bolus tirofiban versus lowdose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Turk Kardiyol Dern Ars. 2017, 45:126- 33.
Velibey Y, Guvenc TS, Demir K, et al.: Effects of bailout Tirofiban on inhospital outcomes and long-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention. Angiology. 2019, 70:431-9.
Vogel B, Claessen BE, Arnold SV, et al.: ST-segment elevation myocardial infarction. Nature reviews Disease primers. 2019, 5:39-10. 10.1038/s41572-019-0090-3
Wang J, Wang DZ: Evaluation on the safety and efficacy of high-dose tirofiban in the primary percutaneous coronary intervention on patients with acute ST-elevation myocardial infarction. Chin Gen Prac. 2015, 18:3276-82.
Wang Y, Wu B, Shu X: Meta-analysis of randomized controlled trials comparing intracoronary and intravenous administration of glycoprotein IIb/IIIa inhibitors in patients with ST-elevation myocardial infarction. Am J Cardiol. 2012, 109:1124-1130.
Wojtukiewicz MZ, Hempel D, Sierko E, et al.: Antiplatelet agents for cancer treatment: a real perspective or just an echo from the past?. Cancer Metastasis Rev. 2017, 36:305-29.
Yang XC, Zhang DP, Wang LF, et al.: Effects of intracoronary or intravenous Tirofiban administration in patients with acute STelevation myocardial infarction undergoing primary percutaneous coronary intervention(Chin). Zhonghua Xin Xue Guan Bing Za Zhi. 2007, 35:517-522.
Zhang Y, Shao T, Yao L, et al.: Effects of tirofiban on stent thrombosis, Hs-CRP, IL-6 and sICAM-1 after PCI of acute myocardial infarction. Exp Ther Med. 2018, 16:3383-8.
Zhao C, Cheng G, He R, et al.: Effects of different routes of tirofiban injection on the left ventricular function and prognosis of patients with myocardial infarction treated with percutaneous coronary intervention. Exp Ther Med. 2015, 9:2401-5.
Published
How to Cite
Issue
Section
Copyright (c) 2023 International journal of health sciences
![Creative Commons License](http://i.creativecommons.org/l/by-nc-nd/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles in this journal, and to use them for any other lawful purpose.
Articles published in IJHS can be copied, communicated and shared in their published form for non-commercial purposes provided full attribution is given to the author and the journal. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
This copyright notice applies to articles published in IJHS volumes 4 onwards. Please read about the copyright notices for previous volumes under Journal History.