Intracoronary Tirofiban vs adenosine in No reflow post PCI, effectiveness & outcomes in TIMI flow: A systematic review

Abstract

Background: This systematic review and meta-analysis was conducted to evaluate the efficacy and safety of intracoronary tirofiban versus adenosine for preventing no-reflow in post PCI patients with TIMI 0-1 flow.

Methodology: The study was conducted in the department of cardiology Hayatabad Medical complex Peshawar from Jan 2020 to Jan 2021. The systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A comprehensive literature search was conducted in the following databases: PubMed, Cochrane Library, Embase, Web of Science, and ClinicalTrials.gov. The search was conducted without any language restriction. The search was limited to randomized controlled trials (RCTs) comparing intracoronary tirofiban versus adenosine for preventing no-reflow post PCI in patients with TIMI 0-1 flow. The search strategy included the following “tirofiban”, “adenosine”, “noreflow”, and “TIMI”. The reference lists of included studies were searched for additional relevant studies. 

Results: A total of 7 studies (n = 1,719) were included in the meta-analysis. Intracoronary tirofiban was significantly associated with a lower risk of total no-reflow (RR = 0.59, 95% CI 0.37–0.94, P = 0.02) as well as MBG 0-2 (RR = 0.39, 95% CI 0.22– 0.69, P = 0.001). There was no significant difference in MACCE between the 2 groups (RR = 0.73, 95% CI 0.43–1.21, P = 0.22).

Conclusion: The results of this systematic review and meta-analysis suggest that intracoronary tirofiban is more effective than adenosine for preventing no-reflow in patients with TIMI flow, with no significant difference in MACCE.