Prehospital tirofiban increases the rate of disrupted myocardial infarction in patients with ST-segment elevation myocardial infarction: insights from the On-TIME 2 trial
In patients with ST-segment elevation myocardial infarction (STEMI), prehospital tirofiban significantly improved myocardial reperfusion. However, its impact on the rate of disrupted myocardial infarction (MI), particularly in the context of high-sensitivity cardiac troponin (hs-cTn) assays, is stil...
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| Main Authors: | , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
August 2024
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| In: |
European heart journal - acute cardiovascular care
Year: 2024, Volume: 13, Issue: 8, Pages: 595-601 |
| ISSN: | 2048-8734 |
| DOI: | 10.1093/ehjacc/zuae074 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1093/ehjacc/zuae074
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| Author Notes: | Sem A.O.F. Rikken, Enrico Fabris, Tobias Rosenqvist, Evangelos Giannitsis, Jurriën M. ten Berg, Christian Hamm, and Arnoud van ‘t Hof |
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| 245 | 1 | 0 | |a Prehospital tirofiban increases the rate of disrupted myocardial infarction in patients with ST-segment elevation myocardial infarction |b insights from the On-TIME 2 trial |c Sem A.O.F. Rikken, Enrico Fabris, Tobias Rosenqvist, Evangelos Giannitsis, Jurriën M. ten Berg, Christian Hamm, and Arnoud van ‘t Hof |
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| 520 | |a In patients with ST-segment elevation myocardial infarction (STEMI), prehospital tirofiban significantly improved myocardial reperfusion. However, its impact on the rate of disrupted myocardial infarction (MI), particularly in the context of high-sensitivity cardiac troponin (hs-cTn) assays, is still unclear.The On-TIME 2 (Ongoing Tirofiban In Myocardial infarction Evaluation 2) trial randomly assigned STEMI patients to prehospital tirofiban or placebo before transportation to a percutaneous coronary intervention (PCI) centre. In this post hoc analysis, we evaluated STEMI patients that underwent primary PCI and had measured hs-cTn levels. Troponin T levels were collected at 18-24 and 72-96 h after PCI. Disrupted MI was defined as peak hs-cTn T levels ≤ 10 times the upper limit of normal (≤140 ng/L). Out of 786 STEMI patients, 47 (6%) had a disrupted MI. Disrupted MI occurred in 31 of 386 patients (8.0%) in the tirofiban arm and in 16 of 400 patients (4.0%) in the placebo arm (P = 0.026). After multivariate adjustment, prehospital tirofiban remained independently associated with disrupted MI (odds ratio 2.03; 95% confidence interval 1.10-3.87; P = 0.027). None of the patients with disrupted MI died during the 1-year follow-up, compared with a mortality rate of 2.6% among those without disrupted MI.Among STEMI patients undergoing primary PCI, the use of prehospital tirofiban was independently associated with a higher rate of disrupted MI. These results, highlighting a potential benefit, underscore the need for future research focusing on innovative pre-treatment approaches that may increase the rate of disrupted MI. | ||
| 700 | 1 | |a Fabris, Enrico |e VerfasserIn |4 aut | |
| 700 | 1 | |a Rosenqvist, Tobias |e VerfasserIn |4 aut | |
| 700 | 1 | |a Giannitsis, Evangelos |e VerfasserIn |0 (DE-588)113336241 |0 (DE-627)577184091 |0 (DE-576)289759579 |4 aut | |
| 700 | 1 | |a ten Berg, Jurriën M |e VerfasserIn |4 aut | |
| 700 | 1 | |a Hamm, Christian |e VerfasserIn |4 aut | |
| 700 | 1 | |a van ‘t Hof, Arnoud |e VerfasserIn |4 aut | |
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