High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention
Objective: Aim of the present study was to determine effects of high-dose versus low-dose intravenous (IV) bolus tirofiban on angiographic measures, ST resolution, enzymatic infarct size, and clinical outcomes in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary i...
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| Format: | Article |
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KARE Publishing
2017-03-01
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| Series: | Türk Kardiyoloji Derneği Arşivi |
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| Online Access: | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-92186 |
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| author | Taner Ulus Utku Şenol Senan Tahmazov Kemal Iskenderov Fezan Mutlu Yüksel Çavuşoğlu |
| author_facet | Taner Ulus Utku Şenol Senan Tahmazov Kemal Iskenderov Fezan Mutlu Yüksel Çavuşoğlu |
| author_sort | Taner Ulus |
| collection | DOAJ |
| description | Objective: Aim of the present study was to determine effects of high-dose versus low-dose intravenous (IV) bolus tirofiban on angiographic measures, ST resolution, enzymatic infarct size, and clinical outcomes in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI) and received current pharmacoinvasive therapy.
Methods: Acute coronary syndrome patients (n=271, 85.6% male; mean age: 57.9+-12.6 years) from between 2009 and 2015 who received IV tirofiban therapy following PCI were retrospectively analyzed. All patients had received maintenance tirofiban infusion (0.15 μg/kg/min) after bolus dose and 600 mg clopidogrel. Percentage of patients undergoing drug eluting stent implantation procedure was 33.5%. Tirofiban was administered to all patients in bailout situation or for thrombotic complication after PCI.

Results: High-dose IV bolus group (25 μg/kg; n=140) was associated with greater ST segment resolution (66% vs. 50%, p=0.013) and reduced peak troponin release [12.4 ng/dL (range: 6.5–21.5 ng/dL) vs. 16.4 ng/dL (range: 10.1–27.4 ng/dL), p=0.001] compared with low-dose bolus group (10 μg/kg, n=131). Cardiovascular event rates were similar between groups at in-hospital, 1-month, and 6-month follow-up (p=1.000, 1.000, and 0.287, respectively). Percentage of patients with post-procedural Thrombolysis in Myocardial Infarction (TIMI) grade III flow, major, and minor bleeding were similar (p=0.085, 1.000, and 0.965, respectively).

Conclusion: Use of high-dose IV bolus tirofiban in addition to aspirin and high-dose clopidogrel improves ST segment resolution, reduces infarct size, and does not increase bleeding events in patients with ACS undergoing PCI compared with low-dose bolus. Angiographic measures and clinical endpoints were similar between groups. |
| first_indexed | 2024-04-10T12:00:18Z |
| format | Article |
| id | doaj.art-5049f90db7a0478c8a092351d8b5ee96 |
| institution | Directory Open Access Journal |
| issn | 1016-5169 |
| language | English |
| last_indexed | 2024-04-10T12:00:18Z |
| publishDate | 2017-03-01 |
| publisher | KARE Publishing |
| record_format | Article |
| series | Türk Kardiyoloji Derneği Arşivi |
| spelling | doaj.art-5049f90db7a0478c8a092351d8b5ee962023-02-15T16:16:38ZengKARE PublishingTürk Kardiyoloji Derneği Arşivi1016-51692017-03-0145212613310.5543/tkda.2016.92186TKDA-92186High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary interventionTaner Ulus0Utku Şenol1Senan Tahmazov2Kemal Iskenderov3Fezan Mutlu4Yüksel Çavuşoğlu5Department Of Cardiology, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyDepartment Of Cardiology, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyDepartment Of Cardiology, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyDepartment Of Cardiology, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyDepartment Of Biostatistics, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyDepartment Of Cardiology, Faculty Of Medicine, Eskişehir Osmangazi University, Eskisehir, TurkeyObjective: Aim of the present study was to determine effects of high-dose versus low-dose intravenous (IV) bolus tirofiban on angiographic measures, ST resolution, enzymatic infarct size, and clinical outcomes in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI) and received current pharmacoinvasive therapy. Methods: Acute coronary syndrome patients (n=271, 85.6% male; mean age: 57.9+-12.6 years) from between 2009 and 2015 who received IV tirofiban therapy following PCI were retrospectively analyzed. All patients had received maintenance tirofiban infusion (0.15 μg/kg/min) after bolus dose and 600 mg clopidogrel. Percentage of patients undergoing drug eluting stent implantation procedure was 33.5%. Tirofiban was administered to all patients in bailout situation or for thrombotic complication after PCI.
 Results: High-dose IV bolus group (25 μg/kg; n=140) was associated with greater ST segment resolution (66% vs. 50%, p=0.013) and reduced peak troponin release [12.4 ng/dL (range: 6.5–21.5 ng/dL) vs. 16.4 ng/dL (range: 10.1–27.4 ng/dL), p=0.001] compared with low-dose bolus group (10 μg/kg, n=131). Cardiovascular event rates were similar between groups at in-hospital, 1-month, and 6-month follow-up (p=1.000, 1.000, and 0.287, respectively). Percentage of patients with post-procedural Thrombolysis in Myocardial Infarction (TIMI) grade III flow, major, and minor bleeding were similar (p=0.085, 1.000, and 0.965, respectively).
 Conclusion: Use of high-dose IV bolus tirofiban in addition to aspirin and high-dose clopidogrel improves ST segment resolution, reduces infarct size, and does not increase bleeding events in patients with ACS undergoing PCI compared with low-dose bolus. Angiographic measures and clinical endpoints were similar between groups.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-92186acute coronary syndromesanti-platelet drugsbleedingtirofiban. |
| spellingShingle | Taner Ulus Utku Şenol Senan Tahmazov Kemal Iskenderov Fezan Mutlu Yüksel Çavuşoğlu High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention Türk Kardiyoloji Derneği Arşivi acute coronary syndromes anti-platelet drugs bleeding tirofiban. |
| title | High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| title_full | High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| title_fullStr | High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| title_full_unstemmed | High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| title_short | High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| title_sort | high dose bolus tirofiban versus low dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| topic | acute coronary syndromes anti-platelet drugs bleeding tirofiban. |
| url | https://jag.journalagent.com/z4/download_fulltext.asp?pdir=tkd&un=TKDA-92186 |
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