Cardiovascular & Hematological Agents in Medicinal Chemistry

(Formerly Current Medicinal Chemistry - Cardiovascular & Hematological Agents)

Debabrata Mukherjee
Department of Internal Medicine Texas Tech University
4800 Alberta Avenue El Paso
Texas, 79905


Safety and Efficacy of Tirofiban as an Adjunctive Therapy for Patients with St-Elevation Myocardial Infarction: A Comparison Versus Placebo and Abciximab

Author(s): Jose F. Diaz, Rosa Cardenal, Antonio Gomez-Manchero and Carlos Sanchez-Gonzalez

Affiliation: Juan Ramon Jimenez University Hospital, Interventional Cardiology Unit, Ronda Norte SN, 21005, Huelva, Spain.


Tirofiban is a nonpeptide tyrosine derivative that together with eptifibatide (both small molecules) and abciximam belongs to the group of glycoprotein IIb/IIIa inhibitors. Though similar to abciximab in that it has a high affinity for the GP IIbIIIa inhibitor receptor, tirofiban dissociates from it much faster tan abciximab, what makes its action reversible in a few hours. Initially used upstream for treatment of patients with non ST-elevation acute coronary síndromes, recent evidence has shown its role as adjuntive therapy in patients with ST-elevation acute myocardial infarction treated with primary angioplasty when used at a higher dose. In this article, we performed a thorough and systematic review of randomized trials comparing tirofiban versus pacebo and tirofiban versus abciximab when used in this subset of patients. All these studies showed tirofiban to be a well tolerated and effective IIbIIIa inhibitor. When compared with placebo, tirofiban was associated with a significant reduction in mortality and myocardial infarction at one month, with a higher risk of minor bleeding in the follow-up. When compared with abciximab, tirofiban showed no difference in mortality and a tendency to higher rate of the composite of death and myocardial infarction in the short term follow-up that disappeared when only studies with high-dose tirofiban were considered. On the basis of the high-dose regimen, tirofiban may be considered useful in the management of patients with ST-elevation myocardial infarction who undergo primary angioplasty.

Keywords: Abciximab, tirofiban, high-dose bolus, upstream, myocardial infarction, primary angioplast,, GPIIbIIIa inhibitors, meta-analysis, stent, bleeding, thrombocytopenia

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Article Details

Page: [147 - 153]
Pages: 7
DOI: 10.2174/187152511797037475