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Singapore Med J ; 51(7): 558-64, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20730395

RESUMO

INTRODUCTION: Glycoprotein IIb/IIIa inhibitors such as tirofiban inhibit platelet aggregation. We evaluated the immediate and early outcomes in patients with high-risk non-ST elevation acute coronary syndrome (NSTE ACS) who received tirofiban with conventional therapy compared to patients who received only conventional therapy (a combination of aspirin, clopidogrel, low-molecular-weight heparin with or without beta-blockers and angiotensin-converting enzyme inhibitors). METHODS: A total of 165 patients received conventional therapy with a placebo, and 136 patients received conventional therapy with tirofiban after randomisation. The outcomes were measured on Day 7, Day 14, one month and three months after the administration of therapy. RESULTS: A significant reduction was noted in the occurrence of primary endpoints in patients receiving tirofiban, compared to those who received a placebo at seven days (14 versus 32; p-value is 0.036), 14 days (14 versus 28; p-value is 0.043), one month (19 versus 34; p-value is 0.01) and three months (30 versus 44; p-value is less than 0.001) after administration. There was a significant reduction in the occurrence of fatal myocardial infarction (MI) (1 versus 8; p-value is 0.044) and non-fatal MI at Day 7 (1 versus 8; p-value is 0.044), and refractory ischaemia at the end of one month (14 versus 24; p-value is 0.04) and three months (25 versus 36; p-value is less than 0.01) in patients receiving tirofiban as compared to those receiving a placebo. CONCLUSION: It may be concluded that tirofiban has a definite role in improving the outcome of patients with high-risk NSTE ACS.


Assuntos
Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/tratamento farmacológico , Inibidores da Agregação Plaquetária/administração & dosagem , Tirosina/análogos & derivados , Síndrome Coronariana Aguda/mortalidade , Idoso , Aspirina/administração & dosagem , Clopidogrel , Relação Dose-Resposta a Droga , Esquema de Medicação , Quimioterapia Combinada , Eletrocardiografia , Serviço Hospitalar de Emergência , Enoxaparina/administração & dosagem , Feminino , Seguimentos , Humanos , Índia , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Valores de Referência , Índice de Gravidade de Doença , Taxa de Sobrevida , Ticlopidina/administração & dosagem , Ticlopidina/análogos & derivados , Tirofibana , Resultado do Tratamento , Tirosina/administração & dosagem
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