Prehospital Triple Antiplatelet Therapy for Acute MI

In a randomized trial, adding high-bolus–dose tirofiban to aspirin and clopidogrel improved ST-segment resolution in patients with acute MI.

In patients with acute ST-segment–elevation MI, early and complete restoration and maintenance of blood flow in the infarct-related artery are associated with improved outcomes. Antiplatelet therapy plays an important role in such treatment, but the incremental benefit of adding platelet-glycoprotein (GP) IIb/IIIa-receptor blockade to early (prehospital) aspirin and high-dose clopidogrel has not been established.

This industry-supported, double-blind, randomized, placebo-controlled trial was conducted at 24 centers in the Netherlands, Germany, and Belgium; and involved 984 patients with STEMI (mean age, 62 years; 76% men) who were eligible for percutaneous coronary intervention. Participants were assigned to receive high-bolus–dose tirofiban…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)