Journal Article10.1016/J.AMJCARD.2008.11.029
Left ventricular function after ST-elevation myocardial infarction in patients treated with primary percutaneous coronary intervention and abciximab or tirofiban (from the Facilitated Angioplasty with Tirofiban or Abciximab [FATA] Trial).
Nevio Taglieri,Francesco Saia,Vincenzo Guiducci,Stefano Tondi,Federico Conrotto,Cinzia Marrozzini,Guido Rocchi,Elena Biagini,Maria Letizia Bacchi Reggiani,Paola Giacometti,Giancarlo Piovaccari,Antonio Manari,Antonio Marzocchi +12 more
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TL;DR: This study showed no difference in LV function recovery in patients undergoing primary PCI treated either with abciximab or high-dose bolus tirofiban.
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Abstract: Abciximab therapy during primary percutaneous coronary intervention (PCI) has shown to ameliorate left ventricular (LV) function recovery in patients with ST elevated myocardial infarction. High-dose bolus tirofiban has similar effect on platelet inhibition. Whether this is associated with comparable efficacy on LV function recovery remains unclear. We sought to evaluate the impact on LV function of high-dose bolus tirofiban or abciximab in patients undergoing primary PCI with the predictors of favorable (≥50%) LV ejection fraction (EF) and LV function recovery at 30 days. We studied 314 patients (abciximab n = 154; tirofiban n = 160) undergoing primary PCI in the randomized Facilitated Angioplasty with Tirofiban or Abciximab (FATA) trial. LVEF was assessed within 48 hours and at 30 days after primary PCI. In patients with systolic dysfunction at baseline, LV function recovery was defined by either increase of LVEF ≥10% compared with baseline or LVEF ≥50%. Similar LVEF was observed in the 2 groups postprocedure (abciximab 49.7 ± 10.1% vs tirofiban 49.3 ± 10.1%, p = 0.9) and at 30 days (abciximab 53.1 ± 9.8% vs tirofiban 52.5 ± 10.2%, p = 0.6). Independent predictors of 30-day LVEF ≥50% were preprocedure Thrombolysis In Myocardial Infarction flow class >0 (odds ratio = 2.4, 95% confidence interval 1.32 to 4.34), anterior location (odds ratio = 0.25, 95% confidence interval 0.15 to 0.42), and age (odds ratio = 0.97, 95% confidence interval 0.95 to 0.99). Preprocedure Thrombolysis In Myocardial Infarction flow grade >0 was the only predictor of LV function recovery (odds ratio = 6.73, 95% confidence interval 2.69 to 16.88). In conclusion, this study showed no difference in LV function recovery in patients undergoing primary PCI treated either with abciximab or high-dose bolus tirofiban. Preprocedure Thrombolysis In Myocardial Infarction flow grade >0 seems to be the most important predictor of favorable LVEF and LV function recovery at 30 days.
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Citations
Comparison of intracoronary versus intravenous administration of tirofiban in primary percutaneous coronary intervention.
Refik Erdim,Demet Erciyes,Selçuk Görmez,Kanber Ocal Karabay,Alp Burak Çatakoğlu,Vedat Aytekin,Cemsid Demiroglu,Murat Gülbaran +7 more
TL;DR: Intracoronary bolus application of tirofiban was not associated with reduction in MACE rates compared to intravenous administration in patients with STEMI who underwent primary PCI.
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Safety evaluation of tirofiban.
Marco Valgimigli,Matteo Tebaldi +1 more
TL;DR: Tirofiban is safe and effective in patients with ACS and the single bolus dose regimen produces potent platelet inhibition resulting in significant improvement in clinical events over placebo when initiated just prior to percutaneous coronary intervention and at first medical contact.
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Prodromal angina and risk of 2-year cardiac mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous intervention
Gabriele Ghetti,Maria Letizia Bacchi Reggiani,Claudia Rosetti,Paola Battistini,Gianluca Lanati,Maria Teresa Di Dio,Anna Corsini,Matteo Bruno,Diego Della Riva,Antonio Bruno,Miriam Compagnone,Riccardo Narducci,Francesco Saia,Claudio Rapezzi,Nevio Taglieri +14 more
TL;DR: In patients with STEMI undergoing PPCI the presence of PA is independently associated with a lower risk of 2-year cardiac mortality, however, the incorporation of this variable to the GRACE score slightly worsened the classification of risk.
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Use of antiplatelet therapies during primary percutaneous coronary intervention for acute myocardial infarction
Łukasz A. Małek,Adam Witkowski +1 more
TL;DR: Intracoronary administration of abciximab and the use of small molecule glycoprotein IIb/IIIa blockers (tirofiban or eptifibatide) challenge the contemporary schemes of antiplatelet treatment in primary PCI.
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Impact of upstream high bolus dose tirofiban on left ventricular systolic function in patients with acute anterior myocardial infarction treated by primary coronary intervention
Haitham Galal,Eman Essmat +1 more
TL;DR: In patients presenting with acute anterior STEMI and treated with primary PCI, the high bolus doses tirofiban given intravenously upstream prior to PCI seems to be a safe and effective regimen to achieve a better left ventricular ejection fraction in comparison to the conventional bolus dose regimen, without increasing the risk of bleeding.
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References
Role of leukocytes in response to acute myocardial ischemia and reflow in dogs.
TL;DR: The significant participation of granulocytes in the unfavorable responses of flow, edema formation, and arrhythmias to the 1st h of myocardial ischemia is demonstrated and their role in the no-reflow phenomenon is document.
585
Effect of Glycoprotein IIb/IIIa Receptor Blockade on Recovery of Coronary Flow and Left Ventricular Function After the Placement of Coronary-Artery Stents in Acute Myocardial Infarction
Franz-Josef Neumann,Rudolf Blasini,Claus Schmitt,Eckhard Alt,J. Dirschinger,Meinrad Gawaz,Adnan Kastrati,Albert Schömig +7 more
TL;DR: Abciximab had important effects beyond the maintenance of large-vessel patency and concomitantly enhanced the recovery of contractile function in the area at risk of acute myocardial infarction.
563
Determinants and Prognostic Implications of Persistent ST-Segment Elevation After Primary Angioplasty for Acute Myocardial Infarction Importance of Microvascular Reperfusion Injury on Clinical Outcome
Marc J. Claeys,Johan Bosmans,Leonard Veenstra,Philippe G. Jorens,Herbert De Raedt,Chris J. Vrints +5 more
TL;DR: Impaired microvascular reperfusion, as evidenced by ST >/=50% after successful recanalization, occurs in more than one third of AMI patients, especially in older patients with low systolic pressure, and its detrimental implications on clinical outcome reinforce the need to develop adjunctive agents that attenuate the process of reperfusions injury.
394
Relation between ST-segment changes and myocardial perfusion evaluated by myocardial contrast echocardiography in patients with acute myocardial infarction treated with direct angioplasty
Giovanni M. Santoro,Renato Valenti,Piergiovanni Buonamici,Leonardo Bolognese,Giampaolo Cerisano,Guia Moschi,Maurizio Trapani,David Antoniucci,Pier Filippo Fazzini +8 more
TL;DR: After successful angioplasty, different patterns of myocardial perfusion are associated with different ST-segment changes, and analysis of ST- segment changes predicts the degree ofMyocardial reperfusion.
248
Predictive factors for development of the no-reflow phenomenon in patients with reperfused anterior wall acute myocardial infarction
Katsuomi Iwakura,Hiroshi Ito,Shigeo Kawano,Yasunori Shintani,Koichi Yamamoto,Akinobu Kato,Masashi Ikushima,Koji Tanaka,M Kitakaze,Masatsugu Hori,Yorihiko Higashino,Kenshi Fujii +11 more
TL;DR: Development of the no-reflow phenomenon is related to the severity of myocardial damage, the size of the risk area (WMS) and the occlusion status of infarct-related artery and ischemic preconditioning (pre-infarction angina) seems to be the factor that attenuates theNo-re flow phenomenon.
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