EFFECT OF TIROFIBAN ON THE OUTCOME DURING HOSPITALIZATION IN PATIENTS WITH ACUTE CORONARY SYNDROME AN OBSERVATIONAL STUDY

  • Thamayanthi K Department of Pharmacology, Government Stanley Medical College, Chennai, Tamil Nadu, India.
  • Arun Ranganathan Departments of Cardiology, Government Stanley Medical College, Chennai, Tamil Nadu, India.
  • Vasanthira K Department of Pharmacology, Government Stanley Medical College, Chennai, Tamil Nadu, India.

Abstract

Objective: The present study was intended to know the effect of tirofiban on the prognostic outcome of patients with acute coronary syndrome (ACS) during their stay in the hospital.

Methods: Registers and case sheets of patients admitted for ACS during May 2014–April 2015 were analyzed retrospectively. The duration of stay in hospital/Intensive Care Unit (ICU) and the outcomes were recorded in patients who received tirofiban. ACS patients who did not receive tirofiban served as control. During the study period, there were 720 patients with ACS, and among them, 216 did not receive tirofiban and 504 patients received tirofiban.

Results: ICU stay (days, mean±standard deviation [SD]) for tirofiban group was longer (2.5±0.5) when compared to the controls (1.5±0.5). However, this was not statistically significant. The duration of hospitalization (days, mean±SD) was not significantly different in both groups (6±0.81 vs. 6±0.82). None of the patients developed reinfarction or persistent pain during their stay in the hospital. There were no major adverse events with tirofiban.

Conclusion: Therefore, it was concluded that tirofiban does not affect the outcome during hospitalization in patients with ACS.

Keywords: Acute coronary syndrome, ST-segment elevation myocardial infarction, non-ST segment elevation myocardial infarction, Tirofiban, Percutaneous coronary intervention.

Author Biography

Thamayanthi K, Department of Pharmacology, Government Stanley Medical College, Chennai, Tamil Nadu, India.

Assistant Pofessor, Dept Of Pharmacology,
Govt. Stanley Medical College

References

1. Scarborough RM, Kleiman NS, Phillips DR. Platelet glycoprotein IIb/IIIa antagonists. What are the relevant issues concerning their pharmacology and clinical use? Circulation 1999;100:437-44.
2. Schneider DJ, Herrmann HC, Lakkis N, Aguirre F, Lo MW, Yin K, et al. The RESTORE Investigators. Effects of platelet glycoprotein IIb/ IIIa blockade with tirofiban on adverse cardiac events in patients with unstable angina or acute myocardial infarction undergoing coronary angioplasty. Circulation 1997;96:1445-53.
3. Merlini PA, Rossi M, Menozzi A, Buratti S, Danielle M, Brennan MS, et al. Thrombocytopenia caused by abciximab or tirofiban and its association with clinical outcome in patients undergoing coronary stenting. Circ Am Heart Assoc 2004;109:2203-6.
4. Kaymaz C, Keleş N, Özdemir N, Tanboğa IH, Demircan HC, Can MM, et al. The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI Esen. Anatolian J Cardiol 2016;15:899-906.
5. Shen J, Zhang Q, Zhang RY, Zhang JS, Hu J, Yang ZK, et al. Clinical benefits of adjunctive tirofiban therapy in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Coron Artery Dis 2008;19:271-7.
6. Martínez-Ríos MA, Rosas M, González H, Peña-Duque MA, Martínez-Sánchez C, Gaspar J, et al. Comparison of reperfusion regimens with or without tirofiban in ST-elevation acute myocardial infarction. Am J Cardiol 2004;93:280-7.
7. Ulus T, Şenol U, Tahmazov S, Iskenderov K, Mutlu F, Çavuşoğlu Y. High-dose bolus tirofiban versus low-dose bolus in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Chin Med J (Engl) 2000;121:500-9.
8. Bilsel T, Akbulut T, Yesilcimen K, Terzi S, Sayar N, Dayi SU, et al. Single high-dose bolus tirofiban with high-loading-dose clopidogrel in primary coronary angioplasty. Chin Med J (Engl) 2006;121:528-9.
9. Fu XH, Hao QQ, Jia XW, Fan WZ, Gu XS, Wu WL, et al. Effect of tirofiban plus clopidogrel and aspirin on primary percutaneous coronary intervention via transradial approach in patients with acute myocardial infarction. Chin Med J (Engl) 2008;121:522-7.
10. Yang XC, Zhang DP, Wang LF, Xu L, Ge YG, Wang HS, et al. Effects of intracoronary or intravenous tirofiban administration in patients with acute ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention. Chin Med J (Engl) 2007;35:517-22.
11. Zhu TQ, Zhang Q, Qiu JP, Jin HG, Lu L, Shen J, et al. Beneficial effects of intracoronary tirofiban bolus administration following upstream intravenous treatment in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention: The ICT-AMI study. Int J Cardiol 2013;165:437-43.
12. Kochman W, Dobrzycki S, Nowak KS, Chlopicki S, Kralisz P, Prokopczuk P, et al. Safety and feasibility of a novel dosing regimen of tirofiban administered in patients with acute myocardial infarction with ST elevation before primary coronary angioplasty: A pilot study. J Thromb Thrombolysis 2004;17:127-31.
13. Gou D, Zhao L. Dongze Efficacy and safety of tirofiban in patients with non-ST segment elevation acute coronary syndromes: A systemic review and meta-analysis. Int J Clin Exp Med 2016;9:15091-104.
14. Schwenkglenks M, Brazier JE, Szucs TD, Fox KA. Cost-effectiveness of bivalirudin versus heparin plus glycoprotein IIb/IIIa inhibitor in the treatment of non-ST-segment elevation acute coronary syndromes. Value Health 2011;14:24-33.
15. Topol EJ, Byzova TV, Plow EF. Platelet GPIIb-IIIa blockers. Lancet 1999;353:227-31.
16. Saibhavana D, Chowta MN, Chowta NK. Critical evaluation of drug promotional literature for drugs used in cardiovascular diseases. Int J Pharm Pharm Sci 2016;7;405-7.
17. Gangarajua S, Manjappaa B, Subbaiaha GK, Kemparaju K, Shindea M, Plow JH, et al. Anticoagulant and antiplatelet activities of jackfruit (Artocarpus heterophyllus) seed extract. Int J Pharm Pharm Sci 2015;7:187-91.
18. Jain HK, Deore DD. Bioanalytical method development and validation for estimation of Clopidogrel bisulfate in human plasma by Rp-Hplc Int J App Pharm 2016;8:18-21.
19. Kabbani SS, Aggarwal A, Terrien EF, DiBattiste PM, Sobel BE, Schneider DJ. Sub-optimal early inhibition of platelets by treatment with tirofiban and implications for coronary interventions. Am J Cardiol 2002;89:647-50.
20. Bollhalder L, Pfeil AM, Tomonaga Y, Schwenkglenks M. A systematic literature review and meta-analysis of randomized clinical trials of parenteral glutamine supplementation. Clin Nutr 2013;32:213-23.
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K, T., A. Ranganathan, and V. K. “EFFECT OF TIROFIBAN ON THE OUTCOME DURING HOSPITALIZATION IN PATIENTS WITH ACUTE CORONARY SYNDROME AN OBSERVATIONAL STUDY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 11, no. 8, Aug. 2018, pp. 388-91, doi:10.22159/ajpcr.2018.v11i8.26065.
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