Abstract
The search for evidence in primary percutaneous coronary intervention (pPCI) has not been straightforward, and has typically consisted of sequences of studies with new, confirmatory, or contradictory information that sometimes bring hope but too often confusion. Most major innovations have gone through this period of doubt, and antiplatelet therapy is no exception. Paradoxically we might have reached the point when new studies, presented or published in the past few months and the study reported in today's Lancet by Arnoud van't Hof and colleagues (the On-TIME 2 trial), 1 van't Hof AWJ ten Berg J Heestermans T et al. on behalf of the Ongoing Tirofiban In Myocardial infarction Evaluation (On-TIME) 2 study groupPrehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME 2): a multicentre, double-blind, randomised controlled trial. Lancet. 2008; 372: 537-546 Summary Full Text Full Text PDF PubMed Scopus (391) Google Scholar have succinctly illuminated the path towards evidence. Prehospital initiation of tirofiban in patients with ST-elevation myocardial infarction undergoing primary angioplasty (On-TIME 2): a multicentre, double-blind, randomised controlled trialOur finding that routine prehospital initiation of high-bolus dose tirofiban improved ST-segment resolution and clinical outcome after PCI, emphasises that further platelet aggregation inhibition besides high-dose clopidogrel is mandated in patients with STEMI undergoing PCI. Full-Text PDF
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