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Background  We conducted a randomized controlled trial to investigate whether an additional platelet inhibition with tirofiban would reduce the extent of myocardial damage and prevent periprocedural myonecrosis in patients with Non-ST-elevation acute coronary syndrome (NSTE-ACS) with a high residual platelet activity (HPR).    Methods  Patients with an HPR, defined as P 2 Y 12  reaction unit (PRU) > 230, were randomly assigned to group A (tirofiban treatment,  n  = 30) or C1 ( n  = 30) and patients without an HPR to C2 ( n  = 78). Periprocedural myocardial damage was assessed using the area under the curve (AUC) of serial cardiac enzyme levels from the time of the procedure to post-36 h. Periprocedural myonecrosis incidence was evaluated.    Results  The troponin I AUC was not different between the groups (197.2 [41.5395.7], 37.9 [8.9313.9], 121.3 [43.7481.8] h∙ng/mL;  p  = 0.088). The results did not change when the baseline levels were adjusted (365.3 [279.5, 451.1], 293.0 [207.1, 379.0], and 298.0 [244.7, 351.3] h∙ng/mL;  p  = 0.487). The rate of periprocedural myonecrosis was also not different between the groups (53.0% vs. 50.0% vs. 33.3%,  p  = 0.092). The CK-MB isoenzyme analysis showed similar results. No difference in complications was noted.    Conclusion  Additional tirofiban administration was not beneficial to patients with NSTE-ACS even with an HPR.    Trial registration  Clinical trial no.  NCT03114995 , registered 11 April, 2017, retrospectively.    Electronic supplementary material  The online version of this article (10.1186/s12872-018-0938-6) contains supplementary material, which is available to authorized users.

bmc cardiovascular disorders

Effect of tailored use of tirofiban in patients with Non-ST-elevation acute coronary syndrome undergoing percutaneous coronary intervention: a randomized controlled trial