Desenlaces clínicos en una cohorte de pacientes con síndrome coronario agudo y administración intracoronaria de tirofiban

Abstract

Introduction: Glycoprotein IIb/IIIa receptor inhibitors reduce major adverse cardiovascularevents (MACE) in patients with acute coronary syndrome.Objective: To determine the major adverse cardiovascular events and safety of intracoronaryand intravenous tirofiban in patients with acute coronary syndrome with percutaneous coronaryintervention (PCI) compared to a group of patients without this medication.Material and methods:Prospective cohort. Adults with acute coronary syndrome from January2010 to December 2012 were included. A proportional hazard regression model after 1 monthof follow up where the risk of MACE and the interest variable was intracoronary and intravenoustirofiban were assessed.Results: 382 patients were included. 46% (174 patients) received intracoronary tirofiban. Theaverage age was 65 years vs. 60 years in the group of non-tirofiban users (p = 0.00). The rate ofMACE at the first month was od 13/1000 events and 15/1000 events respectively in the grouptirofiban and non-tirofiban (log rank test 0,935). The tirofiban use was neither related to a lowerincidence of MACE (HR 1.09 95% IC 0.72 1.65) nor to major bleeding after the first month offollow up (1.72% vs. 2.88% respectively, p = 0.456).Conclusions: Intracoronary and intravenous tirofiban in patients with acute coronary syndromewas neither related to lower incidence of MACE nor to bleeding events; however, it should betaken into account that other clinical variables and the severity of unquantified coronary eventsmight influence the results. © 2015 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular.