BACKGROUND: In the setting of percutaneous coronary revascularization, agents in the class known as platelet glycoprotein IIb/IIIa inhibitors have significantly reduced the incidence of @entity204 or nonfatal @entity583 at 30 days. We assessed whether there are differences in safety or efficacy between two such inhibitors, tirofiban and abciximab. METHODS: Using a double-blind, double-dummy design at 149 hospitals in 18 countries, we randomly assigned @entity1 to receive either tirofiban or abciximab before undergoing percutaneous coronary revascularization with the intent to perform stenting. The primary end point was a composite of @entity204 , nonfatal @entity583 , or urgent target-vessel revascularization at 30 days. The trial was designed and statistically powered to demonstrate the noninferiority of tirofiban as compared with abciximab. RESULTS: The primary end point occurred more frequently among the 2398 @entity1 in the tirofiban group than among the 2411 @entity1 in the abciximab group (7.6 percent vs. 6.0 percent; hazard ratio, 1.26; one-sided 95 percent confidence interval of 1.51, demonstrating lack of equivalence, and two-sided 95 percent confidence interval of 1.01 to 1.57, demonstrating the superiority of abciximab over tirofiban; P=0.038). The magnitude and the direction of the effect were similar for each component of the composite end point (hazard ratio for @entity204 , 1.21; hazard ratio for @entity583 , 1.27; and hazard ratio for urgent target-vessel revascularization, 1.26), and the difference in the incidence of @entity583 between the tirofiban group and the abciximab group was significant (6.9 percent and 5.4 percent, respectively; P=0.04). The relative benefit of abciximab was consistent regardless of age, sex, the presence or absence of @entity6 , or the presence or absence of pretreatment with @entity1397 . There were no significant differences in the rates of major @entity548 complications or transfusions, but tirofiban was associated with a lower rate of minor @entity548 episodes and @entity882 . CONCLUSIONS: Although the trial was intended to assess the noninferiority of tirofiban as compared with abciximab, the findings demonstrated that tirofiban offered less protection from major @entity63 events than did abciximab.

Comparison of two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab, for the prevention of XXXX events with percutaneous coronary revascularization.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity882 :: ('MESH:D013921', 'Disease') :: ['thrombocytopenia'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity63 :: (MESH:D007511,Disease) :: ['ischemic']
