Year 2021, Volume 7 , Issue 1, Pages 12 - 21 2021-01-04

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

Mehmet KAPLAN [1] , İbrahim Halil KURT [2] , Alaa QUISI [3] , Gökhan ALICI [4] , Şerafettin DEMİR [5] , Fethi YAVUZ [6] , Yurdaer DÖNMEZ [7]


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 (STEMI) undergoing primary percutaneous coronary intervention (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 (n = 40) and the double high-dose group (n = 40) according to the intracoronary bolus tirofiban regime. The primary endpoint was assumed as the incidence of major adverse cardiac event (s) (MACE) defined as all-cause mortality and repeat coronary revascularization (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 (40.0% vs. 17.5%, p = 0.994). However, a significantly lower 30-day TVR rate was observed in the double high-dose group (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 (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 (Hazard ratio [HR]: 5.721; 95% CI: 2.036 to 16.073, p = 0.001) and platelet count (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. 

high-dose, glycoprotein IIb/IIIa receptor inhibitor, tirofiban, ST-segment elevation myocardial infarction, efficacy, safety
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Primary Language en
Subjects Cardiac and Cardiovascular Systems
Journal Section Original Articles
Authors

Orcid: 0000-0001-7081-5799
Author: Mehmet KAPLAN (Primary Author)
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0001-5007-2246
Author: İbrahim Halil KURT
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0002-5862-5789
Author: Alaa QUISI
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0002-4589-7566
Author: Gökhan ALICI
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0002-1735-5049
Author: Şerafettin DEMİR
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0003-1913-4212
Author: Fethi YAVUZ
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Orcid: 0000-0003-4745-7801
Author: Yurdaer DÖNMEZ
Institution: Department of Cardiology, University of Health Sciences, Adana City Training and Research Hospital, Adana, Turkey
Country: Turkey


Dates

Application Date : May 5, 2019
Acceptance Date : August 6, 2019
Publication Date : January 4, 2021

EndNote %0 The European Research Journal Efficacy and safety of single high-dose versus double high-dose intracoronary bolus tirofiban in patients with ST-segment elevation myocardial infarction %A Mehmet Kaplan , İbrahim Halil Kurt , Alaa Quısı , Gökhan Alıcı , Şerafettin Demi̇r , Fethi Yavuz , Yurdaer Dönmez %T Efficacy and safety of single high-dose versus double high-dose intracoronary bolus tirofiban in patients with ST-segment elevation myocardial infarction %D 2021 %J The European Research Journal %P -2149-3189 %V 7 %N 1 %R doi: 10.18621/eurj.560531 %U 10.18621/eurj.560531