Stelwagen, P.J. (Piter Jan) (2012) Post-hoc analyse On-TIME 2 : Het effect van vroege toediening van hoge dosering Tirofiban bij patiënten met een ST-elevatie myocard infarct: lange termijn follow-up en herdefiniëring. thesis, Medicine.
Full text available on request.Abstract
Background: The On-TIME 2 (Ongoing Tirofiban In Myocardial Infarction Evaluation 2) trial showed that early administration of Tirofiban in the ambulance improves ST-segment resolution en reduces early stent thrombosis in patients with STEMI undergoing PCI. Tirofiban improved clinical outcome for the composite of death, recurrent MI and urgent target vessel revascularisation and showed a strong trend towards a lower mortality rate at the 1-year follow-up. The effect of Tirofiban on a longer term is unknown. The results in terms of clinical outcome have not yet been analysed in view of the newest expert consensus definitions. Methods: This post-hoc analysis consists of a long term follow-up of total mortality and a redefinition of ischemic and bleeding events within 30 days. This redefinition will be based on the most recent expert consensus definitions, using the data acquired according to the original On-TIME 2 protocol. All analysis will be by intention-to-treat. Results: 1184 of the 1398 On-TIME 2 patiënts were included in the long-term follow-up. With a mean follow-up of 5.41 years, Tirofiban showed no lower mortality rate (log-rank p = 0.67). 731 of the 1398 patients were included in the redefinition. Although 14 new myocardial infarctions were detected, there was no significant difference between Tirofiban and placebo in the incidence of myocardial infarction (p = 0.46). Patients pre-treated with Tirofiban showed more bleeding events (42 vs 22, p = 0.01) compared to placebo. Conclusions: For a subpopulation of the On-TIME 2, long term-follow with a mean of 5,41 years showed no mortality benefit for Tirofiban. The redefinition of bleeding events for another subpopulation showed a higher incidence of bleeding events for patients pre-treated with Tirofiban.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Naam begeleider: and Hof, Arnoud Van ’t and Instelling: Isala klinieken Zwolle/ Diagram and Afdeling: Cardiologie |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:58 |
| Last Modified: | 25 Jun 2020 10:58 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1844 |
Actions (login required)
 |
View Item |