A major international study by cardiologists has shown that the addition of tirofiban into the medical management of patients with unstable angina reduces their risk of death by as much as 47%. Unstable angina is currently the leading cause of admissions to coronary care units, accounting for more than 1.4 million hospitalizations per year in the United States. Tirofiban, a member of a new class of anti-platelet inhibitors, proved so effective in decreasing the incidence of post-angina heart-attacks that the researchers recommended its use as part of a new therapeutic standard of care. The researchers' study and clinical recommendation will be published in the May 21 issue of The New England Journal of Medicine.
Unstable angina is a life-threatening cardiac condition that occurs when bloodflow to the heart muscle is disrupted or impaired. In most cases, the pain of angina is associated with the rupturing of large cholesterol plaques that have built-up, over time, near the outer walls of the heart chamber. "At the present time, we treat this condition with a combination of heparin and aspirin because both of those drugs have unique properties that encourage the dissolution of plaques," explains Howard Herrmann, MD, associate professor of medicine at the University of Pennsylvania Medical Center -- one of the 72 participating trial sites. "Our study showed that the intravenous introduction of tirofiban into the standard treatment protocol provides additional benefit to patients because tirofiban helps prevent the development of plaque deposits by blocking the aggregation of platelets -- which is a precursor to clot development."
In their two-year investigation of 1,915 patients with unstable angina
or non-Q-wave myocardial infarction (which represents the middle ground,
clinically speaking, between angina and a full-blown heart attack), the
researchers tested the effectiveness of tirofiban in addition to heparin and
Contact: Rebecca Harmon
University of Pennsylvania School of Medicine