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- Title
Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry.
- Authors
Rigattieri, Stefano; Lettieri, Corrado; Tiberti, Gianluca; Romano, Michele; Ferlini, Marco; Testa, Luca; Pierini, Simona; Ettori, Federica; Passamonti, Enrico; Marchese, Alfredo; Musumeci, Giuseppe; Esposito, Giovanni; Tarantini, Giuseppe
- Abstract
<bold>Objectives: </bold>To investigate the safety and clinical efficacy of tirofiban during primary percutaneous coronary interventions (pPCI).<bold>Background: </bold>Gp IIb/IIIa inhibitors (GPI) use during pPCI has declined over years, mainly for the increased hemorrhagic risk associated to their use and for the availability of potent, fast-acting oral antiplatelet drugs. However, several pharmacodynamic studies showed suboptimal platelet inhibition with P2Y12-blockers, such as prasugrel or ticagrelor.<bold>Methods: </bold>Patients with ST-segment elevation myocardial infarction (STEMI) undergoing pPCI were prospectively enrolled in a multicenter registry conducted in high-volume centers in Italy. All patients received intraprocedural tirofiban. The primary safety endpoint was the occurrence of in-hospital bleedings according to the Bleeding Academic Research Consortium definition. In-hospital major adverse coronary events (MACE, defined as death, reinfarction, stent thrombosis, and target vessel revascularization), final TIMI flow, myocardial blush grade, and ST-segment resolution were also evaluated.<bold>Results: </bold>A total of 472 patients (mean age 61 ± 11 years, 83% males) were enrolled in 16 Italian centers from October 2015 to June 2018. Mean basal thrombus grade score was 3.47 ± 1.25. PCI was performed by transradial approach in 88% of patients. We observed a very low rate of 30 days BARC bleedings (2.1%) and MACE (0.8%). Complete (>70%) ST-segment resolution was observed in 67% of patients.<bold>Conclusions: </bold>In the FASTER registry, the use of tirofiban during primary PCI, performed with a transradial approach in most cases, in patients with high thrombus burden was associated with high rates of complete ST-segment resolution and low rates of in-hospital bleeding and MACE.
- Subjects
ITALY; PERCUTANEOUS coronary intervention; ST elevation myocardial infarction; TIROFIBAN; REPERFUSION; PLATELET aggregation inhibitors
- Publication
Journal of Interventional Cardiology, 2022, p1
- ISSN
0896-4327
- Publication type
journal article
- DOI
10.1155/2022/9609970