Background: The best treatment option for high-risk patients with unstable coronary syndrome is an early invasive strategy accompanied by intensive anti-platelet therapy. We tested the effect on clinical outcome of ea...Background: The best treatment option for high-risk patients with unstable coronary syndrome is an early invasive strategy accompanied by intensive anti-platelet therapy. We tested the effect on clinical outcome of early coronary angioplasty using a high-dose bolus of tirofiban in patients with non-ST segment elevation acute coronary syndrome. Methods: One hundred and forty consecutive patients with unstable coronary syndrome who underwent an immediate percutaneous coronary intervention with the administration of a high(25 μ g/kg) dose bolus of tirofiban followed by an 18-h infusion of 0.15 μ g kg- 1 min- 1 were compared with a matched control group of 162 patients treated with abciximab. The primary endpoint of the study was the 30- day incidence of major adverse cardiac events; the secondary endpoints were the incidence of major and minor bleeding. Results: The time from admission to PCI was slightly shorter in the tirofiban group(3.9± 4.8 vs. 4.5± 4.4 h; P=0.26). The 30- day rate of major adverse cardiac events was similar in the two groups(6% with tirofiban and 8.6% with abciximab: OR=1.37, 95% CI=0.58- 3.29, P=0.52). No major bleeding episodes were observed; the incidence of minor bleeding was 3.6% in the tirofiban group and 2.5% in the abciximab group(OR=0.68, 95% CI=0.18- 2.59, P=0.74). Conclusions: In this preliminary study, the beneficial effect of the administration of a high-dose tirofiban bolus on 30-day clinical outcomes was similar to that of abciximab in high-risk patients with unstable angina undergoing immediate percutaneous coronary intervention. The results of this therapeutic strategy should be tested in a larger randomised study.展开更多
文摘Background: The best treatment option for high-risk patients with unstable coronary syndrome is an early invasive strategy accompanied by intensive anti-platelet therapy. We tested the effect on clinical outcome of early coronary angioplasty using a high-dose bolus of tirofiban in patients with non-ST segment elevation acute coronary syndrome. Methods: One hundred and forty consecutive patients with unstable coronary syndrome who underwent an immediate percutaneous coronary intervention with the administration of a high(25 μ g/kg) dose bolus of tirofiban followed by an 18-h infusion of 0.15 μ g kg- 1 min- 1 were compared with a matched control group of 162 patients treated with abciximab. The primary endpoint of the study was the 30- day incidence of major adverse cardiac events; the secondary endpoints were the incidence of major and minor bleeding. Results: The time from admission to PCI was slightly shorter in the tirofiban group(3.9± 4.8 vs. 4.5± 4.4 h; P=0.26). The 30- day rate of major adverse cardiac events was similar in the two groups(6% with tirofiban and 8.6% with abciximab: OR=1.37, 95% CI=0.58- 3.29, P=0.52). No major bleeding episodes were observed; the incidence of minor bleeding was 3.6% in the tirofiban group and 2.5% in the abciximab group(OR=0.68, 95% CI=0.18- 2.59, P=0.74). Conclusions: In this preliminary study, the beneficial effect of the administration of a high-dose tirofiban bolus on 30-day clinical outcomes was similar to that of abciximab in high-risk patients with unstable angina undergoing immediate percutaneous coronary intervention. The results of this therapeutic strategy should be tested in a larger randomised study.
