Platelet activation is pivotal in the pathogenesis of acute myocardial infarction (AMI) and in the occurrence of complications after percutaneous coronary interventions (PCI).
1 In the Netherlands, primary PCI is the preferred reperfusion strategy in the treatment of ST-segment elevation myocardial infarction (STEMI) and recent studies in advancing the treatment of STEMI include the use of GP IIb/IIIa receptor inhibitors.
2-5 Most data relate to abciximab, which has been registered for this indication. Specifically, the ADMIRAL (Abciximab before Direct angioplasty and stenting in Myocardial Infarction Regarding Acute and Long-term followup) trial showed that early administration of abciximab in patients with STEMI improves coronary patency, left ventricular function and clinical outcomes.
4 However, data about the use of tirofiban in the setting of STEMI are limited. In the On-Time (ONgoing Tirofiban In Myocardial infarction Evaluation) study, tirofiban started before hospitalisation did not improve TIMI III flow compared with tirofiban started after angiography.
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