Tirofiban – Prevention of MI in unstable angina

NICE recommendations, summary of meeting discussions, links to additional supporting docs etc.

NICE September 2002 (Glycoprotein IIb/IIIa inhibitors for acute coronary syndromes No. 47):

Includes abciximab, eptifibatide, and tirofiban – these drugs should be considered in the management of unstable angina or non-ST-segment-elevation MI.

For patients at high risk of MI or death when early Percutaneous Coronary Intervention (PCI) is desirable but does not occur immediately; either eptifibatide or tirofiban is recommended in addition to other appropriate drug treatment.

A Glycoprotein IIb/IIIa Inhibitor is recommended as an adjunct to PCI:

* when early PCI is indicated but is delayed

* in patinets with diabetes

* if the procedure is complex

NB only abciximab is licensed as an adjunct to PCI.

unstable angina or non-Q-wave myocardial infarction the intravenous use of the glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors (consistent with current UK licensing), in addition to aspirin and low (adjusted) dose unfractionated heparin, is recommended.