Efficacy and safety of tirofiban as an adjunctive therapy in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous transluminal coronary angioplasty

2016-06-23T09-23-22Z
Source: National Journal of Physiology, Pharmacy and Pharmacology
Sanjay Sharma, Seema Gupta, Sanjeev Bhat, Zahid Gillani, Dinesh Kumar, Rajesh Kumar.
Background: The introduction of stents and the use of platelet glycoprotein IIb/IIIa inhibitors, either alone or in combination with reduced-dose fibrinolytic therapy, has allowed percutaneous coronary intervention (PCI) to be performed more safely and synergistically following pharmacologic reperfusion therapy. Aims and Objectives: The present study was conducted to evaluate the efficacy and safety of tirofiban as an adjunct to angioplasty/stenting in acute ST-elevation myocardial infarction (MI) patients. Materials and Methods: A total of 156 consecutive patients diagnosed with acute ST-segment elevation MI (STEMI) presenting within 12 h of symptoms were randomly allocated to primary PCI alone or primary PCI along with tirofiban. Clinical characteristics, angiographic findings (including thrombolysis in MI [TIMI] flow rate), and ST-segment resolution were compared post-procedurally; left ventricular ejection fraction (LVEF) and major adverse cardiac events (MACE, including death, reinfarction, and target vessel revascularization) were compared at 30 days clinical follow-up. Results: Post-procedurally, TIMI Grade 3 reflow was significantly different between two groups (P = 0.01) and was associated with better in-hospital outcomes in tirofiban group compared with control group. Greater resolution of ST-elevation was achieved in patients given tirofiban than in non-tirofiban group, and the results were highly significant. Statistically significant improvement in LVEF was also observed in tirofiban group. There was the non-significant difference in MACE and bleeding complications between two groups. Conclusion: Adjunctive tirofiban therapy for patients with acute STEMI, who underwent primary PCI, seems to be safe and effective treatment modality to achieve improved reperfusion, better LVEF, and clinical outcome at 30 days follow-up.


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