|Title:||Additive benefit of glycoprotein IIb/IIIa inhibition and adjunctive thrombus aspiration during primary coronary intervention: Results of the Initial Thrombosuction and Tirofiban Infusion (ITTI) trial||Authors:||Liu C.-P.
|Issue Date:||2012||Journal Volume:||156||Journal Issue:||2||Start page/Pages:||174-179||Source:||International Journal of Cardiology||Abstract:||
Background: Thrombus aspiration has been shown to provide significant benefits during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). The aim of the current study was to evaluate the additional benefit of tirofiban to thrombus aspiration during primary PCI in myocardial reperfusion. Methods: 100 STEMI patients were randomized according to a 2 × 2 factorial design into 1 of the 4 groups: standard PCI, PCI with initial thrombus aspiration (IT), PCI with tirofiban infusion (TI), and PCI with both treatments (IT + TI). Results: The myocardial blush grade (MBG) 3 was achieved in 30.4%, 45.8%, 56% and 78.6% in the 4 groups respectively. More frequent MBG 3 (p = 0.015) and complete (> 70%) ST-segment resolution (STR, 67.9% vs. 41.7%, p = 0.058) were observed in IT ± TI group compared with IT group. If actuarial analysis was done after reassigning the 2 TI patients who crossed over to IT + TI, the difference between IT + TI and IT groups became more significant (MBG 3 rates: 76.7% vs. 45.8%, p = 0.009; complete STR rates: 70% vs. 41.7%, p = 0.036). Infusion of tirofiban resulted in improved MBG and STR (p = 0.003 and 0.037, respectively). Thrombus aspiration resulted in improved MBG only (p = 0.048) but not in STR. 6-month MACE (death, reinfarction, target lesion revascularization and stroke) was similar among groups (p = 0.725). Conclusions: Tirofiban may augment thrombus aspiration therapy on myocardial reperfusion in primary PCI. The benefit of thrombus aspiration treatment without tirofiban might be less significant, especially on resolution of ST-segment elevation. ? 2010 Elsevier Ireland Ltd.
|ISSN:||0167-5273||DOI:||10.1016/j.ijcard.2010.10.129||metadata.dc.subject.other:||clopidogrel; creatine kinase MB; fibrinogen receptor; heparin; tirofiban; adjuvant therapy; adult; article; clinical effectiveness; continuous infusion; controlled study; drug efficacy; drug targeting; female; heart muscle reperfusion; heart muscle revascularization; heart reinfarction; human; loading drug dose; major clinical study; male; mortality; outcome assessment; percutaneous coronary intervention; preoperative care; priority journal; randomized controlled trial; receptor blocking; ST segment elevation myocardial infarction; stroke; thrombus aspiration; treatment duration; Adult; Aged; Combined Modality Therapy; Coronary Thrombosis; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Platelet Glycoprotein GPIIb-IIIa Complex; Prospective Studies; Suction; Treatment Outcome; Tyrosine
|Appears in Collections:||醫學系|
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