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Dr. Deepak Talreja Case Series on Aggrastat 

Dr. Deepak Talreja presents a case series on the contemporary use of glycoprotein IIb/IIIa inhibitors (GPIs). 

The series is based on cases where patient treatment included Aggrastat (tirofiban hydrochloride) injection and is intended to be an educational resource for fellows and those who may not be familiar with the use of GPIs. 

These cases and testimonials are based on the experiences of a few people. Not all cases are identical. You are not likely to have similar results. 

Important Safety Information about the use of Aggrastat is provided below. 

Clinical studies performance with Aggrastat are provided in the full Prescribing Information. 

About Dr. Deepak Talreja

Dr. Deepak Talreja is an interventional cardiologist with Sentara Cardiology Specialists in Virginia Beach and Chesapeake. Dr. Talreja was integral in helping Sentara Heart Hospital develop its structural heart program.  Here he presents three cases where he used Aggrastat in his practice:

  • Patient Admitted for NSTEMI with Suspected CTO
  • Patient Not Pre-Loaded with DAPT prior to PCI
  • Patient Presenting to the ED with NSTEMI
Dr. Deepak Talreja was provided financial support from Medicure Inc. for the creation of these videos.

Patient Admitted for NSTEMI with Suspected CTO

A 62-year old male presents to the emergency department with lightheadedness, dyspnea, and diaphoresis with jaw aching. He was admitted. He had an initial normal troponin which later elevated to 59. He was diagnosed with ACS NSTEMI and taken to the cardiac catheterization lab. Upon examination, the right coronary artery (RCA) was occluded and could not be successfully wired. Watch to see how Dr. Talreja approached this case. 

Patient Not Pre-Loaded with DAPT prior to PCI

A 72-year old male who present to the hospital as an outpatient. He had a  history of a history of coronary artery bypass grafting (CABG) times 3 two years prior. He now presents with new-onset unstable angina despite increasing guideline driven medical therapy (GDMT).  See how Dr. Talreja approached this case and what he did next. 

Patient Presenting to ED with NSTEMI

A patient presents to ED with non-specific ST changes with new T-wave inversions. His cardiac enzymes were positive suggestive of NSTEMI. His history was notable for previous coronary artery disease (CAD) with a prior ACS treated with a stent to the left anterior descending artery (LAD) and percutaneous transluminal coronary angioplasty (PTCA) of the first diagonal branch 2 years prior. Catheterizations showed occlusion of the mid LAD with collaterals partially filling the distal vessel. See how Dr. Talreja approached this case. 

About Aggrastat

Aggrastat (tirofiban hydrochloride) is indicated to reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).

Aggrastat:

  • Offers protection during the delayed onset of the oral P2Y12 agents*
  • Has a rapid onset, achieving >90% platelet aggregation inhibition within 10 minutes1
  • Is reversible: platelets return to baseline function within 4 to 8 hours of discontinuation of infusion
  • Has no contraindication for patients on hemodialysis
  • Has no drug interactions with oral P2Y12 inhibitors*

* Concomitant use of fibrinolytic, anticoagulants and antiplatelet drugs increases the risk of bleeding.

1 Mardikar HM et al. Am Heart J. 2007;154(344):e1-5
Aggrastat Pharmacy Product

See Cases from Other Interventional Cardiologists 

Check out the experience of other healthcare providers in the US that use Aggrastat to reduce the rate of thrombotic complications for their patients during PCI.

Dr. Saihari Sadanandan

Dr. Kevin Ariani

Dr. Barry Bertolet

Click to see the full list of available cases. 

Important Safety Information

Indication:

Aggrastat® is indicated to reduce the rate of thrombotic cardiovascular events (combined endpoint of death, myocardial infarction, or refractory ischemia/repeat cardiac procedure) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS).

Contraindications:

  • Known hypersensitivity to any component of Aggrastat®.
  • History of thrombocytopenia with prior exposure to Aggrastat®.
  • Active internal bleeding, or history of bleeding diathesis, major surgical procedure or severe physical trauma within the previous month.

Warnings and Precautions:

  • Aggrastat® can cause serious bleeding. Most bleeding associated with Aggrastat® occurs at the arterial access site for cardiac catheterization. Minimize the use of traumatic or potentially traumatic procedures such as arterial and venous punctures, intramuscular injections, nasotracheal intubation, etc. Concomitant use of fibrinolytics, anticoagulants and antiplatelet drugs increases the risk of bleeding. If bleeding cannot be controlled, discontinue Aggrastat®.
  • Thrombocytopenia: discontinue Aggrastat® and heparin.

Adverse Reactions:

  • Bleeding is the most commonly reported adverse reaction.

For additional information, refer to the full Prescribing Information.

You are encouraged to report negative side effects of prescription drugs to the FDA.

Visit www.FDA.gov/medwatch
or call 1-800-FDA-1088.
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