Preliminary experience with a high bolus dose of tirofiban during percutaneous coronary intervention

Abstract

The use of a high bolus dose of tirofiban in patients undergoing PCI seems to be safe and not associated with an increased risk of major bleeding. This high bolus dose may help to further reduce the rate of periprocedural adverse events.

Achieved platelet aggregation inhibition after different antiplatelet regimens during percutaneous coronary intervention for ST-segment elevation myocardial infarction

“…Our results are in accordance with earlier observations during treatment with (high-dose bolus) tirofiban (11,12). Study limitations.…”

“…Improving platelet aggregation inhibition by increasing the bolus dose of the glycoprotein (GP) IIb/IIIa inhibitors has been described in patients undergoing elective or high-risk PCI and in patients with non-ST-segment elevation myocardial infarction (7)(8)(9)(10). This was not associated with an increased risk of major bleeding (11,12). In patients with ST-segment elevation myocardial infarction (STEMI), routine dose of antiplatelet agents may be associated with less effective platelet aggregation inhibition.…”

Randomized Comparison of Upstream Tirofiban Versus Downstream High Bolus Dose Tirofiban or Abciximab on Tissue-Level Perfusion and Troponin Release in High-Risk Acute Coronary Syndromes Treated With Percutaneous Coronary Interventions

“…Recently, Schneider et al (5) have identified a tirofiban bolus of 25 g/kg (followed by maintenance infusion of 0.15 g/kg/min) that achieves inhibition of platelet aggregation Ͼ85% through 60 min. Preliminary reports have documented safety and efficacy of this dose regimen in patients undergoing elective or high-risk PCI (6,7). The role of this regimen in high-risk patients with NSTE-ACS remains to be established.…”

Pharmacodynamics of two different dosing regimens of tirofiban in citrate or PPACK anticoagulated blood

“…However, they used a much lower PPACK concentration and they did not compare citrate and PPACK. Danzi et al [23] showed in 133 consecutive patients that tirofiban given with a bolus of 25).ig/kg and an infusion of 0.15|.ig/kg per min was not associated with an increased risk of major bleeding.…”