Are High-Dose Tirofiban and Drug-Eluting Stents Best for STEMI?

Results of a randomized study favor SES over BMS and show a high-dose bolus of tirofiban to be as good as abciximab.

In this randomized, 2×2 factorial trial, investigators in Italy, Spain, and Argentina compared sirolimus-eluting stents (SES) with bare-metal stents (BMS) and abciximab with tirofiban in 745 patients with acute ST-segment-elevation MI. Abciximab was administered using standard dosing (0.250 mg/kg bolus followed by 12-hour infusion at 0.125 μg/kg/min), but tirofiban was administered as a higher-than-label bolus of 25.00 μg/kg followed by an 18- to 24-hour infusion at 0.15 μg/kg/min. Baseline and procedural characteristics were similar among the four groups.

Eighty-four percent of patients in the abciximab group and 85% of those in the tirofiban group achieved the primary endpoint of 50% ST-segment resolution within 90 minutes of percutaneous …

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI