Abstract 3071: Meta-Analysis of High-Dose Single-Bolus Tirofiban versus Abciximab in Patients Undergoing Percutaneous Coronary Interventions
Background Prior studies with tirofiban (10 μg/kg bolus and 0.15 μg/kg/min infusion) during coronary intervention (PCI) have been associated with higher incidence of adverse cardiac events at 30-days compared to abciximab. We compared the effects of a high-dose bolus of tirofiban (25 μg/kg) and infusion with conventional abciximab regimen on 30-day clinical outcomes in patients undergoing PCI.
Methods A meta-analysis, using data from 5 trials (n=1,392) comparing high-dose tirofiban with abciximab (TENACITY, Bolognese et al, Danzi et al, Gunasekara et al, Valgimigli et al) was performed, and outcomes assessed at 30 days. The primary endpoint was the composite of death, myocardial infarction (MI) and target vessel revascularization (TVR). Major and minor bleeding and incidence of thrombocytopenia were also assessed. A random-effects meta-analysis model was used for the analysis.
Results A total of 689 patients were treated with tirofiban and 703 with abciximab. There were no significant differences among the two groups although there was a trend towards higher incidence of prior PCI in the tirofiban group. The 30-day incidence of the composite of death, MI and TVR was 6.1 % with tirofiban and 7.3% with abciximab (p=0.46). The individual endpoints of death, MI and TVR were also not significantly different in the groups (Figure⇓). There were also no significant differences in major and minor bleeding and thrombocytopenia among the groups.
Conclusions High-dose single-bolus tirofiban may be as effective as abciximab in patients undergoing PCI with a comparable safety profile. Further testing is warranted given short follow-up and limited statistical power with the current analysis