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, Carlos Sanchez-Gonzalez

Journal Name: Cardiovascular & Hematological Agents in Medicinal Chemistry
Formerly Current Medicinal Chemistry - Cardiovascular & Hematological Agents

Volume 9 , Issue 3 , 2011

Become EABM
Become Reviewer


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

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2011
Page: [147 - 153]
Pages: 7
DOI: 10.2174/187152511797037475
Price: $65

Article Metrics

PDF: 16