Abstract
In patients treated with primary coronary angioplasty, the use of abciximab improves
microvascular perfusion and enhances the recovery of contractile function. This study
compared the effects of the new dose regimen of tirofiban (25-μg/kg bolus followed
by an 18-hour infusion at 0.15 μg/kg/min) on left ventricular function with those
of abciximab in patients who underwent direct angioplasty. One hundred patients who
underwent primary coronary angioplasty were randomized to receive a standard dose
of abciximab or a large-dose bolus of tirofiban. The primary end point of the study
was change in the infarct-zone wall motion score index between the initial and 30-day
follow-up echocardiographic studies. The secondary end points were procedural evaluations
before and after Thrombolysis In Myocardial Infarction (TIMI) grade flow, TIMI grade
myocardial perfusion, and corrected TIMI frame count. Baseline global and regional
ventricular functions were similar in the 2 treatment groups. After the procedure,
a TIMI grade 3 flow was obtained in 86% of patients treated with abciximab and 88%
of those receiving tirofiban (p = 1.0), whereas TIMI grade 3 myocardial perfusion
was present in 70% and 76%, respectively (p = 0.65); corrected TIMI frame count was
22.5 ± 1.9 and 22.1 ± 2.5 (p = 0.37). After 30 days, we obtained 87 paired echocardiographic
studies. The infarct-zone wall motion score index decreased from 2.20 ± 0.3 to 1.99
± 0.2 in the abciximab group and from 2.18 ± 0.3 to 1.95 ± 0.3 in the tirofiban group
(p = 0.67). Thus, in patients who had primary coronary angioplasty, abciximab, and
the large-dose bolus of tirofiban showed similar effects on the initial angiographic
results and 30-day recovery of left ventricular function.
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Article info
Publication history
Accepted:
March 19,
2004
Received in revised form:
March 19,
2004
Received:
October 21,
2003
Identification
Copyright
© 2004 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
