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The Anatolian Journal of Cardiology Comparison of intracoronary versus intravenous administration of tirofiban in primary percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. 2010; 10(4): 340-345 | DOI: 10.5152/akd.2010.093  

Comparison of intracoronary versus intravenous administration of tirofiban in primary percutaneous coronary intervention

Refik Erdim1, Demet Erciyes2, Selçuk Görmez1, Kanber Öcal Karabay3, Alp Burak Çatakoğlu1, Vedat Aytekin4, Cemşid Demiroğlu1, Murat Gülbaran5
1Department of Cardiology, Florence Nightingale Hospital, İstanbul
2Florence Nightingale Hastanesi Kardiyoloji Bölümü, İstanbul
3Department of Cardiology, Florence Nightingale Hospital, İstanbul Bilim University, İstanbul, Turkey
4Department of Cardiology, Florence Nightingale Hospital, Istanbul Bilim University, İstanbul, Turkey
5Department of Radiology Florence Nightingale Hospital İstanbul, Turkey Department of Cardiology, Faculty of Medicine, İstanbul Bilim University, İstanbul, Turkey

Objective: The purpose of this study was to compare the intravenous bolus dose of tirofiban with intracoronary bolus dose in primary percutaneous coronary intervention (PCI) with regard to in hospital and six months clinical outcomes and peak cardiac enzyme levels. Methods: We retrospectively examined 84 ST elevation myocardial infarction (STEMI) patients who underwent primary PCI from March 2006 to February 2007. All patients received the systemic bolus dose of tirofiban 10 mcg/kg either via intracoronary (IC) or intravenous (IV) route, followed by a 36 hours of IV infusion at 0.15 mcg/kg/min. Thirty six patients in IC group were compared with 48 patients in IV group in terms of peak cardiac enzyme levels, in-hospital and six months major adverse cardiac events (MACE) rates (death, myocardial infarction and repeat revascularization). Fisher’s exact test, Yates Chi-square, unpaired Student’s t-test and Mann-Whitney U test were used for statistical analysis. Results: There was no difference in cardiovascular risk profile or cardiac history between two groups. At six months the incidence of MACE was 6.25% in IV group and 11.1% in IC group (p=0.45). Peak cardiac phosphokinase (CPK) levels between IV and IC groups were also statistically non significant (2657±2181 U/L in IV group and 2529±1929 U/L in IC group) (p=0.92). Conclusion: 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. Future prospective trials with higher bolus doses of IC tirofiban should addressed to clarify this issue.

Keywords: Myocardial infarction, glycoprotein IIb/IIIa inhibitors, coronary stenting


Refik Erdim, Demet Erciyes, Selçuk Görmez, Kanber Öcal Karabay, Alp Burak Çatakoğlu, Vedat Aytekin, Cemşid Demiroğlu, Murat Gülbaran. Comparison of intracoronary versus intravenous administration of tirofiban in primary percutaneous coronary intervention. Anatol J Cardiol. 2010; 10(4): 340-345


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