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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Effect of tirofiban on percutaneous coronary intervention-induced endothelial dysfunction in patients with stable

Ascan Warnholtz1, Mir Abolfazl Ostad, Thomas Heitzer

  • 1Division of Cardiology, The University Hospital Eppendorf, Hamburg, Germany. warnholtz@2-med.klinik.uni-mainz.de <warnholtz@2-med.klinik.uni-mainz.de>

The American Journal of Cardiology
|December 28, 2004
PubMed

Insights

Percutaneous coronary intervention (PCI) impairs arterial function. Tirofiban, a glycoprotein IIb/IIIa receptor antagonist, significantly improved endothelial function in conductance vessels after PCI, reversing this impairment.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Glycoprotein (GP) IIb/IIIa receptor antagonists improve endothelial dysfunction in resistance vessels.
  • The effect of these antagonists on conductance vessels after percutaneous coronary intervention (PCI) is not well understood.

Purpose of the Study:

  • To evaluate the acute effect of tirofiban on endothelial function of arterial conductance vessels in patients undergoing PCI.

Main Methods:

  • Sixty-six patients undergoing PCI were divided into tirofiban and control groups.
  • Endothelial function was assessed using brachial artery flow-mediated dilation (FMD) before and after PCI.
  • Nitroglycerin-induced vasodilation was also measured.

Main Results:

  • Tirofiban significantly improved FMD post-PCI (6.0% to 7.8%), while FMD deteriorated in the control group (6.1% to 4.7%).
  • Nitroglycerin-induced dilation remained unchanged, indicating specific effects on endothelium-dependent function.
  • Coronary angiography alone did not affect FMD in a separate patient group.

Conclusions:

  • PCI induces endothelial dysfunction in forearm conductance vessels.
  • Tirofiban effectively reverses PCI-induced endothelial dysfunction in these vessels.

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