1. Modulators of Mortality Benefit From Peri-Angioplasty Adjunctive Tirofiban in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
- Author
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Jung-Chung Hsu, Kuo-Chin Chen, Pen-Chih Liao, Wenpo Chuang, Yu-Wei Chiu, Shin-Rong Ke, Ai-Hsien Li, Yen-Wen Wu, Yuan-Hung Liu, and Yen-Ting Yeh
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Population ,030204 cardiovascular system & hematology ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Internal medicine ,Angioplasty ,medicine ,Humans ,cardiovascular diseases ,Myocardial infarction ,Angioplasty, Balloon, Coronary ,education ,Retrospective Studies ,Killip class ,education.field_of_study ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,030229 sport sciences ,General Medicine ,Tirofiban ,medicine.disease ,Treatment Outcome ,Cardiology ,ST Elevation Myocardial Infarction ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Platelet Aggregation Inhibitors ,medicine.drug - Abstract
BACKGROUND Studies investigating the modulators of mortality benefit conferred by peri-angioplasty glycoprotein IIb/IIIa inhibitors in ST-elevation myocardial infarction (STEMI) are still lacking.Methods and Results:A prospective database (n=1,025) of consecutive cases undergoing primary percutaneous coronary intervention for STEMI was retrospectively analyzed. For patients in Killip class I, II or III, IV, the multivariate-adjusted hazard ratios of 30-day all-cause mortality associated with adjunctive tirofiban were 3.873 (95% CI 0.504-29.745; P=0.193), 0.550 (95% CI 0.188-1.609; P=0.275), and 0.264 (95% CI 0.099-0.704; P=0.008), respectively. The P value for a linear trend was 0.032. Patients who had a body mass index (BMI) within 22.9-25.0 kg/m2had a significant benefit from tirofiban (adjusted HR 0.344; 95% CI 0.145-0.814; P=0.015) compared to other BMI groups. The P value for a quadratic trend was 0.012. A novel Killip-BMI score (KBS = 2.5 × Killip category - | BMI - 24 |) was calculated to select the beneficial population. A KBS ≥2 was associated with significant mortality benefit, whereas a KBS
- Published
- 2021