%0 Journal Article
%T Changes in BNP, hs-CRP and TIMI risk index with addition of tirofiban during primary percutaneous coronary intervention for acute STEMI: a prospective observational cohort study
%A £¿brahim Halil Kurt
%A Sait Demirkol
%A £¿lker ¨¹nal
%A Mustafa Kemal Batur
%J Anadolu Kardiyoloji Dergisi
%D 2012
%I Aves Yayincilik
%X Objective: This study aimed to investigate the relationship of tirofiban, added to the treatment of acute ST-elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (PCI), with changes in the TIMI risk index (TRI) of TIMI flow, B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hs-CRP) levels.Methods: This single-center, prospective observational cohort study included 102 consecutive patients who were admitted with the diagnosis of acute STEMI (70 male; 54.9¡À10.4 years). Primary PCI was applied to all cases with STEMI, who applied to our hospital in the first 6 hours due to chest pain complaints. Tirofiban was administered to one group (n=55) (male: 36; 54.1¡À11.3 years), while the other group was not given tirofiban (n=47) (male: 34; 55.9¡À9.1 years). The primary end-point was TIMI flow 2 or 3 for reperfusion after primary PCI. Chi-square test, paired t-test or Wilcoxon signed rank test, Spearman correlation analysis and Kaplan-Meier survival analysis were used for statistical analysis where appropriate.Results: BNP level remained the same in the tirofiban group, whereas a significant increase was observed in the group that was not treated with tirofiban (105.9¡À126.8 versus 261.3¡À202.3 pg/ml p<0.001). The hs-CRP level tended to rise significantly in both groups despite the treatment (tirofiban group - from 0.67¡À0.66 to 0.90¡À0.44 mg/L, p=0.015, non tirofiban group - from 0.51¡À0.43 to 1.08¡À0.74 mg/L, p<0.001). BNP and hs-CRP values remained the same in cases with TIMI 2 flow in the tirofiban group, whereas a significant increase was detected in the post-treatment BNP (before 97.8¡À122.3 after 281.6¡À217.3 pg/ml, p=0.011) and hs-CRP (before 0.65¡À0.69; after 1.33¡À0.80 mg/L, p=0.028) values in the group not treated with tirofiban. In patients with TIMI 3 flow, BNP (tirofiban group before 146.5¡À114.2; after 184.4¡À139.4 pg/ml, p=0.011, non tirofiban group before 172.1¡À297.9; after 295.9¡À384.9 pg/ml, p<0.001) and hs-CRP levels (tirofiban group before 0.66¡À0.58; after 0.92¡À0.65 mg/L, p=0.011, non tirofiban group before 0.81¡À0.74; after 1.45¡À1.23 mg/L, p<0.001) were found to be similarly reduced in both treatment groups p<0.05. Three patients with minor hemorrhage did not need blood transfusion. Conclusion: It was concluded at the end of them PCI application in STEMI that the addition of tirofiban treatment in patients with ¡ÝTIMI 2 flow and anterior location MI could decrease the expected rise in BNP and CRP values.
%K Acute myocardial infarction
%K tirofiban
%K percutaneous coronary intervention
%K TIMI risk index
%K B-type natriuretic peptide
%K high-sensitive C-reactive protein
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