The effect of tirofiban on ST segment resolution in patients with non-ST elevated myocardial infarction
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Date
2004
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Abstract
ST segment resolution in ST elevated myocardial infarction has independent predictive value for congestive heart failure and death at 30 days. ST segment depression in unstable angina pectoris (UAP) and non-ST elevated myocardial infarction (NSTEMI) predicts high risk of MI and death and may discriminate patients likely to have greater benefit from aggressive antithrombotic and interventional therapy. This study assessed the effect of tirofiban added to conventional treatment on ST segment resolution in NSTEMI patients. Sixty-four patients were randomized to one of the two groups: 32 patients received conventional treatment while tirofiban was added in the second group of 32 patients. In the first group, 6 patients refused to participate further after giving initial informed consent while 1 patient in the tirofiban group dropped out. We had 26 patients (mean age, 59 years) in the conventional treatment group and 31 patients (mean age, 59 years) received also tirofiban. Tirofiban was administered by intravenous infusion over a 72 hour period. More than 50% regression of depression was considered to be ST segment resolution. The characteristics of the two groups were comparable (Table I). The ST segment resolution evolution did not differ at the 4th and 24th hours between the two groups. Significant differences occurred in the 72nd hour ECG (Table III). ST resolution was present in 67.9% of the tirofiban patients and in 32.1% of the conventional treatment group (P < 0.05). Tirofiban treatment was not associated with an increase in major bleeding even though there was a trend toward an increase in minor bleeding cases and did not influence the occurrence of refractory angina pectoris.
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Keywords
Electrocardiography , Female , Fibrinolytic Agents , Humans , Infusions, Intravenous , Male , Middle Aged , Myocardial Infarction , Platelet Glycoprotein GPIIb-IIIa Complex , Predictive Value of Tests , Prognosis , Treatment Outcome , Tyrosine , acetylsalicylic acid , anticoagulant agent , beta adrenergic receptor blocking agent , heparin , nitrate , tirofiban , troponin T , drug derivative , fibrinogen receptor , fibrinolytic agent , tirofiban , tyrosine , adult , aged , angiocardiography , article , bleeding , chi square test , clinical trial , congestive heart failure , controlled clinical trial , controlled study , coronary artery recanalization , electrocardiogram , female , follow up , heart infarction , high risk patient , human , major clinical study , male , mortality , prediction , priority journal , randomized controlled trial , rank sum test , ST segment depression , ST segment elevation , statistical significance , treatment outcome , treatment refusal , Turkey (republic) , unstable angina pectoris , drug antagonism , electrocardiography , heart infarction , intravenous drug administration , middle aged , pathophysiology , prediction and forecasting , prognosis