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Dr. Medrdad Kevin Ariani Case Series on Aggrastat 

Dr Ariani 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. Ariani

Dr. Ariani is an interventional cardiologist working out of Dignity Northridge Hospital and Providence Cedars-Sinai Tarzana in San Fernando Valley, CA. Dr. Ariani is the Cardiovascular Service Line Director there. Here he presents three cases where he used Aggrastat in his practice:

  • Slow Reflow following PCI
  • Patient Requiring Urgent Cardiac Catheterization
  • Patient Not Pre-Loading with DAPT
Dr. Medrdad Kevin Ariana was provided financial support from Medicure Inc. for the creation of these videos. 

Slow Reflow following PCI

A 66 year-old female with a history of coronary artery disease presented with chest pains. An initial coronary angiogram reveals a severely calcified lesion in the proximal to mid left anterior descending artery (LAD). Rotational atherectomy and angioplasty were performed, however, the patient developed slow flow. Intravascular ultrasound imaging revealed a significant amount of intra-arterial thrombus. See how Dr. Ariani handled this case.  

Patient Requiring Urgent Cardiac Catheterization

53 year-old male presents to the emergency room with acute anterior wall myocardial infarction. The patient was hemodynamical unstable and was having crushing chest pain and blood pressure was quite labile. He was rushed for an urgent cardiac catheterization. Initial imaging revealed 100% occlusion of the proximal LAD. See what happened next.

Patient Not Pre-Loaded with DAPT prior to PCI

69-year old female with extensive history of coronary artery disease was brought to the cardiac catheterization laboratory electively. A coronary angiography revealed a significant lesion of the LAD. An iFR measurement of the LAD was performed which equated to 0.84. A decision was made to proceed with rotational atherectomy. Watch the full video to see how Dr. Ariani 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. Barry Bertolet

Dr. Deepak Talreja

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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