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To the Editor: We would like to raise some points regarding the report of the STRATEGY trial by Dr Valgimigli and colleagues.¹ The study compared adjuvant tirofiban plus sirolimus-eluting stenting vs abciximab plus bare-metal stenting in the context of acute ST-segment elevation myocardial infarction (STEMI) and found no significant differences in the rate of major adverse cardiovascular events at 30 days. However, target vessel revascularization (TVR) and target lesion revascularization were significantly less frequent in the tirofiban plus sirolimus-eluting stent group at 8 months, a finding that also drove the reduction in major adverse cardiovascular events for that group. The strategy of using different glycoprotein IIb/IIIa receptor antagonists in the 2 groups was based on the higher cost implications of abciximab (compared with tirofiban) and drug-eluting stents.

A high-dose bolus of tirofiban was used in the hope of reducing periprocedural risk of myocardial infarction while lowering overall procedural costs. However, . . . [Full Text of this Article]

Faizel Osman, MB, BCh, MRCP
f.osman@bham.ac.uk

Sohail Qaisar, MB, BS, MRCP; Nadia El Gaylani, MB, ChB, MRCP; Michael Pitt, MB, ChB, FRCP
Department of Cardiology
Birmingham Heartlands
Birmingham, United Kingdom

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