GPIIbIIIa Inhibitors in the RESCUe and RESURCOR Networks at the Acute Myocardial Infarction

Comparison of Administration of Tirofiban in the Ambulance or in the Cathlab in Patients With Acute Myocardial Infarction Treated With Primary Angioplasty

In patients with acute myocardial infarction who are managed in the prehospital setting, and who will treated with primary angioplasty, we evaluate the benefit of an early administration of tirofiban, a powerful GPIIbIIIa inhibitors. Patients are randomised to early administration in the ambulance or administration in the cathlab. The primary endpoint is TIMI 2-3 flow in the first coronary opacification of the culprit artery.

Inclusion Criteria:

• Age > 18 years
• Information given to the patient and consent obtained
• Thoracic pain or symptoms of infarction
• Symptoms < 12 hours
• ST deviation identified by electrocardiography (ECG) in at least 2 contiguous leads
• Transfer time to angioplasty room evaluated by the coordinating doctor as less than 90 minutes (from ECG diagnosis to arrival in angioplasty room)

Exclusion criteria

• Physiological or pathological conditions not compatible with a revascularisation procedure (in the acute phase of myocardial infarction (MI)
• Administration of fibrinolytics or another antiGPIIBIIIa in the previous seven days
• Contraindications to aspirin or tirofiban or heparin
• Diagnosed severe kidney failure (dialysis, creatinin > 350µmol/l
• Pregnancy
• Time for transfer to the angioplasty room evaluated by coordinating doctor as more than 90 minutes
• Subject participating in another trial
• Subject with high hemorrhagic risk.