The PRISM-PLUS study enrolled 362 patients with diabetes [1], (Table 1). All patients had presented with prolonged or repetitive chest pain with either significant ECG changes or enzymatic evidence of myocardial necrosis.

Table 1. PRISM-Plus: Demographics of patients with diabetes.

Among the diabetic subgroup, treatment with tirofiban and heparin was associated with an 87% decrease in the composite end point of MI or death at 7 days compared with heparin monotherapy (p=0.004). This benefit was sustained at 30 days (15.5% vs. 4.7%, p=0.002) and 6 months (19.2% vs. 11.2%, p=0.044).

Fig. 1 PRISM-Plus: MI/death outcomes in patiens with diabetes.

Théroux et al. Circulation 1998; 98 1-359.

The benefit of tirofiban was directly related to a decrease in recurrent MI risk.

Fig. 2. PRISM-Plus: MI in patients with diabetes.

Théroux et al. Circulation 1998; 98 1-359.

Thus, the addition of tirofiban to heparin monotherapy in diabetic patients presenting with an acute coronary syndrome results in dramatic sustained reductions in recurrent MI risk.

1. Théroux P, Ghannan A, Nesmith J, et al. Improved cardiac outcomes in diabetic unstable angina/non-Q-wave myocardial infarction treated with tirofiban and heparin. Circulation 1998; 98: I-359.


Last modified: October 14, 1999 (PL)





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