Usefulness of tirofiban among patients treated without percutaneous coronary intervention (TIMI high risk patients in PRISM-PLUS)

The American Journal of Cardiology
David A MorrowPierre Theroux

Abstract

Although the efficacy of glycoprotein IIb/IIIa inhibition in non-ST-elevation acute coronary syndromes is greatest in patients who undergo percutaneous coronary intervention (PCI), it was hypothesized that high-risk patients managed without PCI also benefit. The TIMI risk score was calculated for 1,570 patients randomized to tirofiban plus heparin versus heparin in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms trial. In high-risk patients (score > or =4) treated without PCI, tirofiban reduced the risk for death, myocardial infarction, and refractory ischemia at 30 days (28.8% vs 21.9%; odds ratio [OR] 0.69, p = 0.04). This benefit was similar in magnitude as that for patients who underwent PCI (32.4% vs 22.2%; OR 0.60, p = 0.06). No benefit was evident in low-risk patients.

References

May 23, 1998·The New England Journal of Medicine·UNKNOWN Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS)
Aug 11, 2000·JAMA : the Journal of the American Medical Association·E M AntmanE Braunwald
Jul 10, 2003·Journal of the American College of Cardiology·Eric D PetersonUNKNOWN National Registry of Myocardial Infarction (NRMI) 4 Investigators

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Citations

Jan 13, 2006·Current Treatment Options in Cardiovascular Medicine·Benjamin M Scirica, David A Morrow
Dec 19, 2008·American Journal of Therapeutics·Rohit R Arora, Fasi Rai
Mar 31, 2007·BMJ : British Medical Journal·A Khavandi, P R Walker
Nov 13, 2008·Current Problems in Cardiology·Michael D Faulx, Gary S Francis
Feb 15, 2008·The American Journal of Emergency Medicine·William E BodenChadwick D Miller

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