Intravenous versus intracoronary bolus of glycoprotein IIb/IIIa inhibitor administration during primary percutaneous coronary intervention on long-term left ventricular systolic and diastolic function

Pellicori, Pierpaolo; Torromeo, Concetta; Barillà, Francesco; Madon, E; Evangelista, A.; Truscelli, Giovanni; Costanzo, Pierluigi; Hoye, Angela; Wong, Kenneth

doi:10.5603/cj.2013.0077

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…Over the last decade, the best therapy for acute myocardial infarction (MI) has been PPCI to achieve full reperfusion and hence reduce mortality [20]. The benefits of PCI include increased myocardial blood flow and a normal TIMI flow grade, resulting in a lower risk of cardiovascular events [21]. When percutaneous coronary intervention is performed, the vascular complication becomes more prevalent, leading to a rise in the number of fatalities as well as an expensive burden on the patient.…”

Section: Discussionmentioning

confidence: 99%

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Iqbal¹,

Iqbal²,

Ali³

et al. 2022

PJMHS

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Background and Aim: Thrombosis within the coronary arteries causes ST-elevation myocardial infarction. STEMI can be vascularized by primary PCI, which is class-I indication and the gold standard. The present study aimed to assess the outcome of pericardial tirofiban administration in patients with ST-level myocardial infarction following primary percutaneous coronary intervention. Patients and Methods: This cross-sectional study was conducted on 228 ST-elevation myocardial infarction (STEMI) patients in the Bahawalpur Heart Center, Bahawalpur for the duration of Six months from March 2022 to September 2022. Patients of both gender having an age range 25 to 65 years with STEMI were enrolled and categorized into two groups based on Tirofiban administration are as follows: Group-I comprised of Tirofiban group and Group-II control (non-tirofiban group). All the patients underwent primary percutaneous coronary intervention (PCI). Major bleeding, MACE, TIMI Grade flow, hematoma, myocardial blush, minor bleeding, and mortality were different variables measured. SPSS version 28 was used for data analysis. Results: The overall mean age was 42.82± 10.26 years. Of the total 228 STEMI patients, there were 166 (72.8%) male and 62 (27.2%) were females. The mean age of group-I (n=114) and group-II (n=114) was 41.74 ± 11.62 years and 43.9± 8.9 years. The age-wise distribution of patients were as follows: 74 (32.5%) in 25-35 years, 70 (30.7%) in 36-45 years, 64 (28.1%) in 46-55 years, and 20 (8.8%) in 56-65 years. The prevalence of hypertension, diabetes, and smoker in Tirofiban and non-tirofiban group was 32 (28.1%) vs. 34 (29.8%), 24 (21.1%) vs. 28 (24.6%), and 31 (27.2%) vs. 33 (28.9%) respectively. A p-value of 0.05 indicated that there was an independent difference in TIMI flow grades between the two groups. Based on clinical outcomes, the incidence of partial reperfusion TIMI flow grade, normal myocardial blush grade, major bleeding, MACE, hematoma, minor bleeding, and mortality was found in 72 (31.6%), 146 (64%), 60 (26.3%), 68 (29.8%), 61 (26.8%), 52 (22.8%), and 8 (3.5%) respectively. Conclusion: The present study found that patients with severe thrombus burden and STEMI who underwent emergency coronary intervention received intracoronary tirofiban treatment that was simple, safe, and effective. A significant difference in TIMI flow and myocardial blush grades was observed when intracoronary Tirofiban was administered to STEMI patients undergoing percutaneous coronary intervention compared with patients who did not receive intracoronary Tirofiban. Keywords: Intracoronary Tirofiban, Percutaneous coronary intervention, ST-elevation myocardial infarction, Outcomes

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Section: Discussionmentioning

confidence: 99%

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Iqbal¹,

Iqbal²,

Ali³

et al. 2022

PJMHS

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“…No beneficial effect of GP IIb/IIIa inhibitors in elderly patients can be the result of distal embolisation of coronary vessels or myocardial perfusion impairment (De Luca et al, 2014). Other researchers have found that GP IIb/IIIa inhibitors had meaningful influence on higher ejection fraction after STEMI (Pellicori et al, 2013).…”

Section: -Month Follow-upmentioning

confidence: 99%

Factors determining exercise capacity evaluated during cardiopulmonary exercise testing in 6‐month follow‐up after ST elevation myocardial infarction

Turski

Kocierz-Woźnowska

Wybraniec

et al. 2019

Clin Physio Funct Imaging

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Summary Introduction ST elevation myocardial infarction (STEMI) is one of the main causes of congestive heart failure (CHF). The main symptom of CHF is exercise tolerance impairment. The aim of the study was to evaluate the prevalence and risk factors for impaired exercise tolerance in patients after STEMI. Methods and Results A total of 84 patients with STEMI were analysed in the study. Cardiopulmonary exercise test (CPET) was performed 6 months after STEMI. Impaired exercise tolerance defined as peak VO2 < 84% predicted for age and sex was present in 49 (58%) patients and was connected with lack of abciximab administration (91.4 versus 69%, P = 0·02) and the presence of mitral regurgitation (47 versus 23%, P = 0·02). In univariate analysis, the troponin I level at admission (OR 1·89, P = 0·047), the use of abciximab (OR 0·21, P = 0·03), the presence of mitral regurgitation (OR 2·98, P = 0·03) and NT‐proBNP concentration (OR 2·17, P = 0·021) were related to impaired exercise tolerance. The best multivariate model for predicting impaired exercise tolerance included mitral regurgitation and lack of abciximab administration. Conclusions Impaired exercise tolerance after STEMI is common. Mitral regurgitation and lack of abciximab administration are the best predicting factors of impaired exercise tolerance after STEMI.

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“…Recently the topic of intracoronary use of abciximab has been extensively discussed in the literature [52][53][54][55][56]. This administration route seems to provide a much higher concentration of abciximab in the target area and possibly allow direct influence not only on the platelet GP IIb/IIIa receptor, but also on vitronectin and Mac-1 receptors, enhancing dose-dependent off-target effects of abciximab.…”

Section: Abciximabmentioning

confidence: 99%

Off-target effects of glycoprotein IIb/IIIa receptor inhibitors

et al. 2014

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Intravenous versus intracoronary bolus of glycoprotein IIb/IIIa inhibitor administration during primary percutaneous coronary intervention on long-term left ventricular systolic and diastolic function

Cited by 6 publications

References 36 publications

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

The Outcome of Intracoronary Tirofiban Administation at Primary Percutenous Coronary Intervention in ST-Elevation Myocardial Infarction Patients

Factors determining exercise capacity evaluated during cardiopulmonary exercise testing in 6‐month follow‐up after ST elevation myocardial infarction

Off-target effects of glycoprotein IIb/IIIa receptor inhibitors

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