Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention

Enrico Fabris; Jan Paul Ottervanger; Renicus S. Hermanides; Jurrien M. ten Berg; Gianfranco Sinagra; Petra C. Koopmans; Evangelos Giannitsis; Christian Hamm; Arnoud W. J. van 't Hof

doi:10.1002/ccd.28043

Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention

Enrico Fabris, Jan Paul Ottervanger, Renicus S. Hermanides, Jurrien M. ten Berg, Gianfranco Sinagra, Petra C. Koopmans, Evangelos Giannitsis, Christian Hamm, Arnoud W. J. van 't Hof^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

ObjectivesTo investigate the potential association between early tirofiban treatment and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after primary percutaneous coronary intervention (PCI).

BackgroundWhether the use of adjunctive early glycoprotein IIb/IIIa inhibitors (GPIs) therapy, may affect the level of NT-proBNP after primary PCI is poorly studied.

MethodsNine hundred and eighty four ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI were randomized to either pre-hospital tirofiban administration or placebo. NT-proBNP levels were evaluated on admission before angiography (baseline) and 18-96hr after PCI.

ResultsThere were 918 (93.3%) patients with NT-proBNP values available at baseline and 865 (87.9%) post-PCI. Post-PCI NT-proBNP level dichotomized with median value as cut-off (968.8 pg/mL, IQR 430.9-1970.0) was significantly lower in patients treated with early tirofiban as compared to placebo (45.5% vs. 54.2% P=0.011). At multivariate logistic regression analysis, independent predictors of post-PCI NT-proBNP level above the median were: NT-proBNP baseline level (OR 5.19; 95% CI, 2.92-9.25, PI (OR 4.07; 95% CI 1.24-13.36, P=0.021), anterior infarct location (OR 2.61; 95% CI 1.84-3.70, P

ConclusionsIn a large cohort of STEMI patients, pre-hospital tirofiban administration was independently associate with a lower risk of high NT-proBNP level after primary PCI, supporting the potential benefit of early antithrombotic treatment administration in STEMI patients. The trial is registered under No. ISRCTN06195297.

Original language	English
Pages (from-to)	E293-E297
Number of pages	5
Journal	Catheterization and Cardiovascular interventions
Volume	93
Issue number	5
DOIs	https://doi.org/10.1002/ccd.28043
Publication status	Published - 1 Apr 2019

Keywords

glycoprotein IIb
IIIa inhibitors
NT-proBNP
STEMI
tirofiban
ELEVATION MYOCARDIAL-INFARCTION
ST-SEGMENT ELEVATION
PROGNOSTIC VALUE
MORTALITY
REPERFUSION
INITIATION
ADMISSION
INSIGHTS
EXTENT

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10.1002/ccd.28043

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Fabris, E., Ottervanger, J. P., Hermanides, R. S., ten Berg, J. M., Sinagra, G., Koopmans, P. C., Giannitsis, E., Hamm, C., & van 't Hof, A. W. J. (2019). Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention. Catheterization and Cardiovascular interventions, 93(5), E293-E297. https://doi.org/10.1002/ccd.28043

@article{648a3baa80c148b0819c171b3ee3b642,

title = "Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention",

abstract = "ObjectivesTo investigate the potential association between early tirofiban treatment and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after primary percutaneous coronary intervention (PCI).BackgroundWhether the use of adjunctive early glycoprotein IIb/IIIa inhibitors (GPIs) therapy, may affect the level of NT-proBNP after primary PCI is poorly studied.MethodsNine hundred and eighty four ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI were randomized to either pre-hospital tirofiban administration or placebo. NT-proBNP levels were evaluated on admission before angiography (baseline) and 18-96hr after PCI.ResultsThere were 918 (93.3%) patients with NT-proBNP values available at baseline and 865 (87.9%) post-PCI. Post-PCI NT-proBNP level dichotomized with median value as cut-off (968.8 pg/mL, IQR 430.9-1970.0) was significantly lower in patients treated with early tirofiban as compared to placebo (45.5% vs. 54.2% P=0.011). At multivariate logistic regression analysis, independent predictors of post-PCI NT-proBNP level above the median were: NT-proBNP baseline level (OR 5.19; 95% CI, 2.92-9.25, PI (OR 4.07; 95% CI 1.24-13.36, P=0.021), anterior infarct location (OR 2.61; 95% CI 1.84-3.70, PConclusionsIn a large cohort of STEMI patients, pre-hospital tirofiban administration was independently associate with a lower risk of high NT-proBNP level after primary PCI, supporting the potential benefit of early antithrombotic treatment administration in STEMI patients. The trial is registered under No. ISRCTN06195297.",

keywords = "glycoprotein IIb, IIIa inhibitors, NT-proBNP, STEMI, tirofiban, ELEVATION MYOCARDIAL-INFARCTION, ST-SEGMENT ELEVATION, PROGNOSTIC VALUE, MORTALITY, REPERFUSION, INITIATION, ADMISSION, INSIGHTS, EXTENT",

author = "Enrico Fabris and Ottervanger, {Jan Paul} and Hermanides, {Renicus S.} and {ten Berg}, {Jurrien M.} and Gianfranco Sinagra and Koopmans, {Petra C.} and Evangelos Giannitsis and Christian Hamm and {van 't Hof}, {Arnoud W. J.}",

note = "Publisher Copyright: {\textcopyright} 2018 Wiley Periodicals, Inc.",

year = "2019",

month = apr,

day = "1",

doi = "10.1002/ccd.28043",

language = "English",

volume = "93",

pages = "E293--E297",

journal = "Catheterization and Cardiovascular interventions",

issn = "1522-1946",

publisher = "Wiley",

number = "5",

}

Fabris, E, Ottervanger, JP, Hermanides, RS, ten Berg, JM, Sinagra, G, Koopmans, PC, Giannitsis, E, Hamm, C & van 't Hof, AWJ 2019, 'Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention', Catheterization and Cardiovascular interventions, vol. 93, no. 5, pp. E293-E297. https://doi.org/10.1002/ccd.28043

Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention. / Fabris, Enrico; Ottervanger, Jan Paul; Hermanides, Renicus S. et al.
In: Catheterization and Cardiovascular interventions, Vol. 93, No. 5, 01.04.2019, p. E293-E297.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effect of early tirofiban administration on N-terminal pro-B-type natriuretic peptide level in patients treated with primary percutaneous coronary intervention

AU - Fabris, Enrico

AU - Ottervanger, Jan Paul

AU - Hermanides, Renicus S.

AU - ten Berg, Jurrien M.

AU - Sinagra, Gianfranco

AU - Koopmans, Petra C.

AU - Giannitsis, Evangelos

AU - Hamm, Christian

AU - van 't Hof, Arnoud W. J.

PY - 2019/4/1

Y1 - 2019/4/1

N2 - ObjectivesTo investigate the potential association between early tirofiban treatment and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after primary percutaneous coronary intervention (PCI).BackgroundWhether the use of adjunctive early glycoprotein IIb/IIIa inhibitors (GPIs) therapy, may affect the level of NT-proBNP after primary PCI is poorly studied.MethodsNine hundred and eighty four ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI were randomized to either pre-hospital tirofiban administration or placebo. NT-proBNP levels were evaluated on admission before angiography (baseline) and 18-96hr after PCI.ResultsThere were 918 (93.3%) patients with NT-proBNP values available at baseline and 865 (87.9%) post-PCI. Post-PCI NT-proBNP level dichotomized with median value as cut-off (968.8 pg/mL, IQR 430.9-1970.0) was significantly lower in patients treated with early tirofiban as compared to placebo (45.5% vs. 54.2% P=0.011). At multivariate logistic regression analysis, independent predictors of post-PCI NT-proBNP level above the median were: NT-proBNP baseline level (OR 5.19; 95% CI, 2.92-9.25, PI (OR 4.07; 95% CI 1.24-13.36, P=0.021), anterior infarct location (OR 2.61; 95% CI 1.84-3.70, PConclusionsIn a large cohort of STEMI patients, pre-hospital tirofiban administration was independently associate with a lower risk of high NT-proBNP level after primary PCI, supporting the potential benefit of early antithrombotic treatment administration in STEMI patients. The trial is registered under No. ISRCTN06195297.

AB - ObjectivesTo investigate the potential association between early tirofiban treatment and N-terminal pro-B-type natriuretic peptide (NT-proBNP) level after primary percutaneous coronary intervention (PCI).BackgroundWhether the use of adjunctive early glycoprotein IIb/IIIa inhibitors (GPIs) therapy, may affect the level of NT-proBNP after primary PCI is poorly studied.MethodsNine hundred and eighty four ST-elevation myocardial infarction (STEMI) patients undergoing primary PCI were randomized to either pre-hospital tirofiban administration or placebo. NT-proBNP levels were evaluated on admission before angiography (baseline) and 18-96hr after PCI.ResultsThere were 918 (93.3%) patients with NT-proBNP values available at baseline and 865 (87.9%) post-PCI. Post-PCI NT-proBNP level dichotomized with median value as cut-off (968.8 pg/mL, IQR 430.9-1970.0) was significantly lower in patients treated with early tirofiban as compared to placebo (45.5% vs. 54.2% P=0.011). At multivariate logistic regression analysis, independent predictors of post-PCI NT-proBNP level above the median were: NT-proBNP baseline level (OR 5.19; 95% CI, 2.92-9.25, PI (OR 4.07; 95% CI 1.24-13.36, P=0.021), anterior infarct location (OR 2.61; 95% CI 1.84-3.70, PConclusionsIn a large cohort of STEMI patients, pre-hospital tirofiban administration was independently associate with a lower risk of high NT-proBNP level after primary PCI, supporting the potential benefit of early antithrombotic treatment administration in STEMI patients. The trial is registered under No. ISRCTN06195297.

KW - glycoprotein IIb

KW - IIIa inhibitors

KW - NT-proBNP

KW - STEMI

KW - tirofiban

KW - ELEVATION MYOCARDIAL-INFARCTION

KW - ST-SEGMENT ELEVATION

KW - PROGNOSTIC VALUE

KW - MORTALITY

KW - REPERFUSION

KW - INITIATION

KW - ADMISSION

KW - INSIGHTS

KW - EXTENT

U2 - 10.1002/ccd.28043

DO - 10.1002/ccd.28043

M3 - Article

C2 - 30585388

SN - 1522-1946

VL - 93

SP - E293-E297

JO - Catheterization and Cardiovascular interventions

JF - Catheterization and Cardiovascular interventions

IS - 5

ER -