Tirofiban is a nonpeptide tyrosine derivative that together with eptifibatide (both small molecules) and abciximam belongs to the group of glycoprotein IIb/IIIa inhibitors. Though similar to abciximab in that it has a high affinity for the GP IIbIIIa inhibitor receptor, tirofiban dissociates from it much faster tan abciximab, what makes its action reversible in a few hours. Initially used upstream for treatment of patients with non ST-elevation acute coronary síndromes, recent evidence has shown its role as adjuntive therapy in patients with ST-elevation acute myocardial infarction treated with primary angioplasty when used at a higher dose. In this article, we performed a thorough and systematic review of randomized trials comparing tirofiban versus pacebo and tirofiban versus abciximab when used in this subset of patients. All these studies showed tirofiban to be a well tolerated and effective IIbIIIa inhibitor. When compared with placebo, tirofiban was associated with a significant reduction in mortality and myocardial infarction at one month, with a higher risk of minor bleeding in the follow-up. When compared with abciximab, tirofiban showed no difference in mortality and a tendency to higher rate of the composite of death and myocardial infarction in the short term follow-up that disappeared when only studies with high-dose tirofiban were considered. On the basis of the high-dose regimen, tirofiban may be considered useful in the management of patients with ST-elevation myocardial infarction who undergo primary angioplasty.
Objetivo: Analizar el aporte que realizan los Corresponsales No bancarios (CNB) a la inclusión financiera (InF), considerando las diferentes dimensiones. Método: Estudio de tipo analítico observacional bajo la metodología de encuestas y entrevistas llevadas a cabo en una zona de la población rural aplicada tanto a usuarios como a CNB. Resultados: Los principales hallazgos evidenciaron que los servicios financieros ofrecidos por los CNB reflejan características de acceso, aunque exteriorizando riesgos de liquidez; y por parte de la población objetivo refleja un uso limitado especialmente por la desconfianza y los costos transaccionales. Discusiones: No es del todo claro que la estrategia de los CNB sea la única que se deba impulsar para obtener mayor inclusión financiera en la población desatendida. Los CNB están siendo utilizados en su mayor parte como recaudadores de pagos a empresas públicas y privadas. Conclusiones: Los servicios más utilizados en los CNB no implican la inclusión de la población desatendida. Por otro lado, los servicios como apertura de cuentas básicas, depósitos y retiros relacionados, se sujetan a tarifas que deben ser pagadas por los usuarios y que no diferencian de las tarifas de los servicios de los canales tradicionales de la banca.
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