Article ; Online: Comparison of Ischemic and Bleeding Events Between Short-Duration Versus Long-Duration Tirofiban Regimens in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention.
Journal of cardiovascular pharmacology
2022 Volume 80, Issue 1, Page(s) 56–61
Abstract: Abstract: Tirofiban has been used historically as a bridge to platelet inhibition with clopidogrel in ST-segment myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) to prevent stent thrombosis. However, ticagrelor and prasugrel ...
| Abstract | Abstract: Tirofiban has been used historically as a bridge to platelet inhibition with clopidogrel in ST-segment myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) to prevent stent thrombosis. However, ticagrelor and prasugrel reach similar levels of platelet inhibition at 30 minutes to that of clopidogrel at 6 hours, challenging the need for long-duration tirofiban. This 1-year, retrospective cohort study compared ischemic and bleeding outcomes of short-duration versus long-duration tirofiban regimens in patients with STEMI who received ticagrelor or prasugrel at the time of PCI. The primary outcome was major adverse cardiovascular events (MACEs) including cardiovascular mortality, recurrent myocardial infarction, urgent target vessel revascularization, or stroke. Secondary outcomes included individual MACE, all-cause mortality, bleeding events defined by the International Society on Thrombosis and Hemostasis, thirty-day readmissions for MACE and bleeding, and tirofiban pharmacy cost. A total of 283 charts were reviewed and 177 included (short duration n = 57; long duration n = 120). MACE rates were similar between short-duration and long-duration groups (0 [0%] vs. 5 [4.2%]; P = 0.18), including 4 cardiovascular deaths and 1 recurrent myocardial infarction. Bleeding event rates were also similar in short-duration versus long-duration groups including major bleeds (2 [3.5%] vs. 2 [1.7%]; P = 0.60) and clinically relevant nonmajor bleeds (3 [5.3%] vs. 9 [7.5%]; P = 0.75). Cost analysis indicated lower pharmacy cost with the short-duration group. In this cohort of patients with STEMI receiving a fast-acting P2Y12 inhibitor, the length of tirofiban infusion did not affect ischemic or bleeding outcomes, yet short-duration regimens were lower cost. |
|---|---|
| MeSH term(s) | Clopidogrel/adverse effects ; Hemorrhage/chemically induced ; Humans ; Myocardial Infarction/chemically induced ; Myocardial Infarction/diagnosis ; Myocardial Infarction/therapy ; Percutaneous Coronary Intervention/adverse effects ; Platelet Aggregation Inhibitors/adverse effects ; Prasugrel Hydrochloride/adverse effects ; Retrospective Studies ; ST Elevation Myocardial Infarction/diagnosis ; ST Elevation Myocardial Infarction/therapy ; Thrombosis/chemically induced ; Ticagrelor/adverse effects ; Tirofiban/adverse effects ; Treatment Outcome |
| Chemical Substances | Platelet Aggregation Inhibitors ; Clopidogrel (A74586SNO7) ; Prasugrel Hydrochloride (G89JQ59I13) ; Tirofiban (GGX234SI5H) ; Ticagrelor (GLH0314RVC) |
| Language | English |
| Publishing date | 2022-07-01 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 391970-5 |
| ISSN | 1533-4023 ; 0160-2446 |
| ISSN (online) | 1533-4023 |
| ISSN | 0160-2446 |
| DOI | 10.1097/FJC.0000000000001289 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.A 1471: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.