Effectiveness of tirofiban for failed thrombolysis during acute myocardial infarction

Vetrano, Alfredo; Carotenuto, Raffaele; Corsini, F; Schioppa, M; Martone, Angela; Melorio, Saverio; Sideri, Francesca; Romano, Salvatore; Chieffo, Carmelo; Corsini, G

doi:10.1016/j.amjcard.2003.12.035

Cited by 3 publications

(2 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Il trombolitico utilizzato nel gruppo in studio è stato l'alteplasi secondo GUSTO [8] nel 95%, il tenecteplase nel 5%. In 12 pazienti ultrasettantacinquenni in cui la trombolisi non ha indotto entro 120 minuti regressione di oltre il 50% nella sommatoria del sopraslivellamento del segmento ST (trombolisi fallita), abbiamo utilizzato il tirofiban, inibitore delle GP IIb/IIIa [10].…”

Section: Terapiaunclassified

Acute myocardial infarction in the elderly. A case-control study with a younger population and review of literature

Corsini

Scaglione

Iacomino

et al. 2016

Monaldi Arch Chest Dis

Self Cite

View full text Add to dashboard Cite

IntroduzioneNegli ultimi decenni la popolazione d'età superiore ai 75 anni è cresciuta in modo rilevante costituendo in Italia nel 2002 circa l'8% di quella globale e, secondo le previsioni dell'Istituto Superiore di Sanità (ISTISAN), raggiungerà il 10% nel 2010. In questa fascia d'età si registra una netta prevalenza di donne rispetto agli uomini.I dati epidemiologici dimostrano che le malattie cardiovascolari costituiscono la principale causa di morte e d'invalidità degli anziani. Infatti la cardiopatia ischemica nelle sue diverse espressioni cliniche, in particolare l'infarto miocardico acuto (IMA), diventa, in entrambi i sessi, sempre più frequente con l'avanzare dell'età. Da notare che, sempre in base ai dati ISTISAN, mentre la malattia coronarica è decisamente più presente nei maschi al di sotto dei 70 anni di età, la sua incidenza si dimostra invece francamente più elevata nelle femmine che hanno superato i 75 anni nei confronti dei maschi coetanei. Vi è evidenza clinica che circa il 20% di maschi e femmine, all'età di 80 anni, abbia malattia coronarica. Negli Stati Uniti circa il 60% di tutti i pazienti ospedalizzati per IMA, sono ultrasessantacinquenni.L'infarto miocardico acuto nell'ultrasettantacinquenne. Studio caso-controllo con una popolazione più giovane e rassegna della letteratura Results: The mean interval between the onset of symptoms and the arrive in CCU was of 9 hour in the elderly compared to 4,5 hour in the control. Chest pain was less frequent (50% vs 90%) in the elderly; the prevalence of dyspnoea and neurological symptoms was higher in patients >75 years (30% vs 15% and 25% vs 10%). In the elderly, previous angina and AMI, cerebral and peripheral vascular diseases, peripheral and renal failure were frequent. Early severe complications prevailed in the elderly. Thrombolysis was performed only in 39% of the elderly compared to 65% of the control. Significantly higher was cerebral haemorrhage after thrombolysis (4,9% vs 1,8%). Comparable were the mayor extra cranial bleedings. Primary or facilitated PTCA was performed in few patients in the last year. Two weeks mortality was 20%, compared to 6,5% in the control group.Conclusion: The patientes >75 years with STEMI were hospitalized later, had atypical presentation with less chest pain and more cardiac failure, were less likely to receive thrombolysis, had more complications and more cerebral bleedings. Elderly had more associated diseases and in-hospital mortality was higher.

show abstract

Section: Terapiaunclassified

Acute myocardial infarction in the elderly. A case-control study with a younger population and review of literature

Corsini

Scaglione

Iacomino

et al. 2016

Monaldi Arch Chest Dis

Self Cite

View full text Add to dashboard Cite

show abstract

“…Incidence of death during hospitalization was also high in the control group. In a study conducted by Vetrano, Corotenuto et al, 13 .…”

Section: Materials and Methods: One Hundredmentioning

confidence: 99%

Untitled

2017

IJPSR

View full text Add to dashboard Cite

ABSTRACT:We studied the feasibility, safety, clinical benefit, efficacy and 30 day outcome in 50 patients receiving tirofiban in patients with failed thrombolysis in acute ST elevation myocardial infarction, and compared with 50 patients for age, gender and infarct location, who did not receive rescue treatment for different reasons. Tirofiban resulted in an overall ST segment elevation, resolution, at 240 minutes in 44 patients (88 %). Incidence of major events during hospitalization was higher in control group. One patient (2 %) died in study group against 4(8%) in control group while 4 patients had refractory angina needing early percutaneous coronary intervention as compared to 13 in control group. None reinfarcted as against 4 in control group. Two patients developed congestive heart failure against 8 in control group. However, minor bleeding events (mainly gum) were significantly higher, 9 against 0 in control group. Coronary angiography revealed residual thrombus only in 4 patients treated with tirofiban compared to 13 in controls and surprisingly the number of stents required were less in study group (74 % i.e. 37 patients) against (96 % i.e. 48 patients) in control group. On 30 day follow up no death, congestive heart failure or repeat revascularization procedure was recorded in the study group with significant improvement in left ventricular ejection fraction, while as there were 3 deaths and 4 patients had congestive heart failure in control group INTRODUCTION: Success rate of intravenous thrombolysis is close to 70 %. Therefore stratigies for failed thrombolysis or reocclusion/ reinfarction also need to be planned in advance. Ongoing chest pain, non-resolution of ECG i.e. failure of the elevated ST segment to fall by 50% or more in lead with maximal ST elevation recorded 90 minutes after onset of thrombolysis, hemodynamic or electric instability indicate failure of recanalization. Repeat thrombolysis with the same or other agent is not to be practiced.

show abstract

Guidelines for the management of acute coronary syndromes 2006

2006

Medical Journal of Australia

View full text Add to dashboard Cite

Effectiveness of tirofiban for failed thrombolysis during acute myocardial infarction

Cited by 3 publications

References 12 publications

Acute myocardial infarction in the elderly. A case-control study with a younger population and review of literature

Acute myocardial infarction in the elderly. A case-control study with a younger population and review of literature

Untitled

Guidelines for the management of acute coronary syndromes 2006

Contact Info

Product

Resources

About