In a European Study, Prehospital Use of a GP IIb/IIIa Inhibitor Improved Outcomes After PCI in STEMI Patients

The most effective time to administer antiplatelet therapy in patients with ST-segment-elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) is unclear. One component of triple antiplatelet treatment is a glycoprotein IIb/IIIa inhibitor, such as tirofiban. Investigators in Europe performed a double-blind, randomized, placebo-controlled, multicenter, manufacturer-supported trial to assess the effect of prehospital bolus administration of high-dose tirofiban on outcomes after PCI in patients with STEMI. Patients with cardiogenic shock, severe renal insufficiency, or persistent severe hypertension were excluded.

Of 984 PCI candidates, 491 received tirofiban (25 µg/kg bolus and 0.15 µg/kg/minute maintenance…