Tirofiban MetaAnalysis

1
Tirofiban Meta-Analysis
2
Tirofiban Meta-Analysis Efficacy at 30 Days
Administration Pre-Angiography (Upstream) and
PCI Likely (Downstream)
Plt.00001
of Patients
P.001
12 ?g/kg bolus over 30 min (upstream) and 10
?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
3
Tirofiban Meta-Analysis Death or MI at 30 Days
Administration Pre-Angiography (Upstream) and
PCI Likely (Downstream)
P.002
P.006
of Patients
P.07
m
m
m
Bolus over 30 Minutes (Upstream)
During PCI (Downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
4
Tirofiban Meta-Analysis Mortality at 30 Days
Administration Pre-Angiography (Upstream) and
PCI Likely (Downstream)
P.01
of Patients
P.07
P.25
m
m
m
Bolus over 30 Minutes (Upstream)
During PCI (Downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
5
Tirofiban Meta-Analysis Safety at 30 Days
Administration Pre-Angiography (Upstream) and
PCI Likely (Downstream)
P.002
of Patients
P.24
12 ?g/kg bolus over 30 min (upstream) and 10
?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
6
Tirofiban Meta-Analysis Efficacy at 30 Days
Administration when PCI Likely or Planned
(Downstream)
P.11
of Patients
P.70
10 ?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
7
Tirofiban Meta-Analysis Death or MI at 30 Days
Administration when PCI Likely or Planned
(Downstream)
P.03
P.54
of Patients
m
m
10 ?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
8
Tirofiban Meta-Analysis Mortality at 30 Days
Administration when PCI Likely or Planned
(Downstream)
P.38
of Patients
P.65
m
m
10 ?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
9
Tirofiban Meta-Analysis Safety at 30 Days
Administration when PCI Likely or Planned
(Downstream)
Plt.001
of Patients
P.04
10 ?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
10
Tirofiban Meta-Analysis Death or MIat Long-Term
Follow Up
Administration when PCI Likely or Planned
(Downstream)
P.34
P.10
P.35
of Patients
m
m
10 ?g/kg bolus 25 ?g/kg bolus (downstream)
Valgimigli M, et al. EHJ. Published online
September 14, 2009.
11
Tirofiban Meta-Analysis Key Points

• Tirofiban when compared with placebo or
  bivalirudin at 30 days
• Significantly reduced mortality and the composite
  of death or MI
• 12 mg/kg Bolus (label) administered over 30
  minutes (Upstream)
• Significantly reduced mortality and the composite
  of death or MI
• 25 mg/kg Bolus (Downstream)
• Significantly reduced the composite of death or
  MI
• Significantly increased TIMI minor bleeding and
  thrombocytopenia
• Demonstrated no significant difference in TIMI
  major bleeding

12
Tirofiban Meta-Analysis Key Points

• Tirofiban when compared with abciximab
  (Downstream only)
• Demonstrated no significant difference in
  mortality and the composite of death or MI at 30
  days or long-term follow up
• 10 mg/kg Bolus TARGET Trial (Downstream)
• Demonstrated a significant increase in the
  composite of death or MI at 30 days, which was
  lost at long-term follow up
• Demonstrated no significant difference in
  mortality at 30 days or at long-term follow up
• 25 mg/kg Bolus (Downstream)
• Demonstrated no significant difference in
  mortality or the composite of death or MI at 30
  days or at long-term follow up
• Significantly reduced TIMI minor bleeding and
  thrombocytopenia
• Demonstrated no significant difference in TIMI
  major bleeding