Effect of intracoronary and intravenous administration of tirofiban loading dose in patients underwent percutaneous coronary interventions because of acute coronary syndrome

• Published in: Kardiologiia Vol. 53; no. 1; p. 23
• Main Authors: Turkmen, S, Fettser, D V, Kagliian, K É, Serchelik, A, Arystanova, A Zh, Tekin, K, Balli, M, Batyraliev, T A, Samko, A N, Sidorenko, B A
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 2013
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Aspirin - administration & dosage; Aspirin - adverse effects; Dose-Response Relationship, Drug; Drug Administration Routes; Drug Monitoring; Electrocardiography; Female; Hemorrhage - chemically induced; Humans; Length of Stay; Male; Middle Aged; Percutaneous Coronary Intervention - methods; Platelet Aggregation Inhibitors - administration & dosage; Platelet Aggregation Inhibitors - adverse effects; Preoperative Care - methods; Retrospective Studies; Survival Analysis; Ticlopidine - administration & dosage; Ticlopidine - adverse effects; Ticlopidine - analogs & derivatives; Treatment Outcome; Tyrosine - administration & dosage; Tyrosine - adverse effects; Tyrosine - analogs & derivatives
• ISSN: 0022-9040

Aim of this multicenter retrospective study was assessment of effect of intracoronary administration of tirofiban loading dose in troponin positive patients with acute coronary syndrome (ACS). We analyzed multicenter data base of patients subjected to percutaneous coronary interventions (PCI) because of ST-elevation or non-ST elevation ACS from October 2010 to October 2011. Patients who received loading doses of aspirin (300 mg) and clopidogrel (600 mg) before PCI and tirofiban (10 mg/kg bolus with subsequent infusion 0.15 mg/kg/min for 24 h) were selected for the study (n=133, 89 with intravenous and 44 - intracoronary administration of tirofiban loading dose). We assessed hospital mortality, myocardial reinfarctions (reMI), necessity of target vessel revascularization (TVR) and pronounced bleedings. There were no significant differences in mortality, reMI, and TVR between two groups. However major adverse cardiac events was significantly less in patients who received intracoronary tirofiban (6.8 vs. 21.3% in i.v. group; p=0.046). Hospital stay was significantly shorter in intracoronary compared with i.v. group (3.84+/-0.96 vs. 4.55+/-1.11 days; p=0.001). Rates of bleedings did not differ significantly between groups. Thus compared with i.v. intracoronary administration of tirofiban loading dose allows lower rate of major adverse cardiac events as well as to shorten length of hospital stay of patients with ACS.