effect of additional temporary glycoprotein IIb/IIIa receptor inhibition on troponin release in elective percutaneous coronary interventions after pretreatment with aspirin and clopidogrel (TOPSTAR trial)
Andreas W. Bonz, MD*,*,
Björn Lengenfelder*,
J.örg Strotmann, MD*,
Stefanie Held, MD*,
Oliver Turschner, MD*,
Kerstin Harre, MD*,
Christian Wacker, MD*,
Christiane Waller, MD*,
Nikolaus Kochsiek, MD*,
Malte Meesmann, MD*,
Ludwig Neyses, MD*,
Peter Schanzenbächer, MD*,
Georg Ertl, MD* and
Wolfram Voelker, MD*
* Department of Cardiology, University of Würzburg, Würzburg, Germany
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Figure 1 Flow-chart of the TOPSTAR trial. After diagnostic catheterization the patients were pretreated with aspirin (ASA) and clopidogrel. After randomization the patients underwent elective percutaneous coronary intervention (PCI) in a second stage procedure with either peri- and postprocedural placebo or tirofiban infusion for 18 h. For details see Methods sections.
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Figure 2 Platelet function before and after percutaneous coronary intervention. During tirofiban infusion platelet function was inhibited down to 10% of the initial value. Platelet activation was observed in the placebo group. Solid bar = tirofiban (n = 50); open bar = placebo (n = 46). ***p < 0.001; *p < 0.05. Data ± SEM.
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Figure 3 Percentage of patients with positive troponin after successful percutaneous coronary intervention up to 12 h, 24 h and 48 h. Solid bar = tirofiban (n = 50); open bar = placebo (n = 46). *p < 0.05.
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Figure 4 Combined end point of death/myocardial infarction (MI)/target vessel revascularization (TVR) after 30 days and nine months indicating a significant reduction in the tirofiban-treated group after nine months.
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