Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry
Objectives. To investigate the safety and clinical efficacy of tirofiban during primary percutaneous coronary interventions (pPCI). Background. 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 availabi...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2022/9609970 |
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| author | Stefano Rigattieri Corrado Lettieri Gianluca Tiberti Michele Romano Marco Ferlini Luca Testa Simona Pierini Federica Ettori Enrico Passamonti Alfredo Marchese Giuseppe Musumeci Giovanni Esposito Giuseppe Tarantini |
| author_facet | Stefano Rigattieri Corrado Lettieri Gianluca Tiberti Michele Romano Marco Ferlini Luca Testa Simona Pierini Federica Ettori Enrico Passamonti Alfredo Marchese Giuseppe Musumeci Giovanni Esposito Giuseppe Tarantini |
| author_sort | Stefano Rigattieri |
| collection | DOAJ |
| description | Objectives. To investigate the safety and clinical efficacy of tirofiban during primary percutaneous coronary interventions (pPCI). Background. 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. Methods. 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. Results. 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. Conclusions. 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. |
| format | Article |
| id | doaj-art-aa7aca73ff7b4b43b260744ef3063437 |
| institution | Kabale University |
| issn | 1540-8183 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-aa7aca73ff7b4b43b260744ef30634372025-08-20T03:39:35ZengWileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/9609970Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter RegistryStefano Rigattieri0Corrado Lettieri1Gianluca Tiberti2Michele Romano3Marco Ferlini4Luca Testa5Simona Pierini6Federica Ettori7Enrico Passamonti8Alfredo Marchese9Giuseppe Musumeci10Giovanni Esposito11Giuseppe Tarantini12Interventional CardiologyCardiology DepartmentCardiovascular DepartmentCardiology DepartmentCardiology DepartmentDepartment of CardiologyOspedale BassiniCardiology UnitOspedale di CremonaInterventional CardiologyCardiology DepartmentDepartment of Advanced Biomedical SciencesDepartment of CardiacObjectives. To investigate the safety and clinical efficacy of tirofiban during primary percutaneous coronary interventions (pPCI). Background. 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. Methods. 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. Results. 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. Conclusions. 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.http://dx.doi.org/10.1155/2022/9609970 |
| spellingShingle | Stefano Rigattieri Corrado Lettieri Gianluca Tiberti Michele Romano Marco Ferlini Luca Testa Simona Pierini Federica Ettori Enrico Passamonti Alfredo Marchese Giuseppe Musumeci Giovanni Esposito Giuseppe Tarantini Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry Journal of Interventional Cardiology |
| title | Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry |
| title_full | Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry |
| title_fullStr | Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry |
| title_full_unstemmed | Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry |
| title_short | Primary Percutaneous Coronary Intervention with High-Bolus Dose Tirofiban: The FASTER (Favorite Approach to Safe and Effective Treatment for Early Reperfusion) Multicenter Registry |
| title_sort | primary percutaneous coronary intervention with high bolus dose tirofiban the faster favorite approach to safe and effective treatment for early reperfusion multicenter registry |
| url | http://dx.doi.org/10.1155/2022/9609970 |
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