Efficacy and safety of single high-dose versus double high-dose intracoronary bolus tirofiban in patients with ST-segment elevation myocardial infarction

Authors : Mehmet KAPLAN, İbrahim Halil KURT, Alaa QUISI, Gökhan ALICI, Şerafettin DEMİR, Fethi YAVUZ, Yurdaer DÖNMEZ

Pages : 12-21

Doi:10.18621/eurj.560531

View : 23 | Download : 9

Publication Date : 2021-01-04

Article Type : Research Paper

Abstract :Objectives: We evaluated the efficacy and safety of single high-dose versus double high-dose intracoronary bolus tirofiban in patients with ST-segment elevation myocardial infarction insert ignore into journalissuearticles values(STEMI); undergoing primary percutaneous coronary intervention insert ignore into journalissuearticles values(PCI);. Methods: A total of 80 patients, who were admitted to our clinic and underwent primary PCI, were included in this observational cohort study. The patients were divided into the single high-dose group insert ignore into journalissuearticles values(n = 40); and the double high-dose group insert ignore into journalissuearticles values(n = 40); according to the intracoronary bolus tirofiban regime. The primary endpoint was assumed as the incidence of major adverse cardiac event insert ignore into journalissuearticles values(s); insert ignore into journalissuearticles values(MACE); defined as all-cause mortality and repeat coronary revascularization insert ignore into journalissuearticles values(target vessel revascularization [TVR]); at 30 days. MACE and bleeding events were evaluated at 7 and 30 days. Results: The primary endpoint was not significantly different between the single and the double high-dose groups insert ignore into journalissuearticles values(40.0% vs. 17.5%, p = 0.994);. However, a significantly lower 30-day TVR rate was observed in the double high-dose group insert ignore into journalissuearticles values(27.5% vs. 7.5%, p = 0.019);. No significant difference was observed in terms of 30-day all-cause mortality between the two groups insert ignore into journalissuearticles values(12.5% vs. 10.0%, p = 0.712);. Major bleeding events were not observed in any group. Multivariate logistic regression analysis demonstrated that CRUSADE score insert ignore into journalissuearticles values(Hazard ratio [HR]: 5.721; 95% CI: 2.036 to 16.073, p = 0.001); and platelet count insert ignore into journalissuearticles values(HR: 1.009; 95% CI: 1.000 to 1.018, p = 0.048); were the independent predictors of bleeding at 7 days. Conclusions: Double high-dose intracoronary bolus tirofiban in STEMI patients undergoing primary PCI was associated with significantly lower 30-day TVR rates without an increase in bleeding events. However, it did not significantly affect MACE and all-cause mortality rates. 
Keywords : high dose, glycoprotein IIb IIIa receptor inhibitor, tirofiban, ST segment elevation myocardial infarction, efficacy, safety