Background: The TARGET study has been criticised for suboptimal platelet inhib ition with tirofiban. We aimed to compare a high-dose bolus regimen of tirofiba n(hd-tirofiban) to standard dose of abciximab for patients undergoing percutane ous coronary intervention(PCI). Methods: We assessed consecutive patients who re ceived either hd-tirofiban(25 mcg/kg bolus followed by 0.15 mcg/kg/min infusion for 18 h) or standard dose abciximab. In-hospital and 6-month outcomes were o btained in all cases. Results: Over an 18-month period, 109 patients who receiv ed hd-tirofiban were compared with 110 patients who received abciximab. Both hd -tirofiban and abciximab groups had acute coronary syndromes in 86%and 80%and diabetes in 10%and 13%respectively. Most patients had coronary stent implanta tion(96%vs. 98%). Thrombocytopenia(platelet count< 100,000) developed in 0.9% of patients receiving hd-tirofiban and 2%of patients receiving abciximab(p=0.5 66). Bleeding requiring transfusion occurred in 7.3%and 3%of patients respecti vely(p=0.118). Peri-procedural troponin rise was 0.9%in patients receiving hd -tirofiban and 5.5%in patients receiving abciximab(p=0.07). MACE(Myocardial in farction, Stroke, Revascularisation and Death) at 6 months was 23%in the hd-ti rofiban group and 20%in the abciximab group(p=0.711). The pharmaceutical costs were AUD 322 for hd-tirofiban(one ampoule) and AUD 1350 for abciximab(3 ampoule s). Conclusion: There was a small increase in bleeding requiring transfusion and a lower rate of peri-procedural troponin rise in the hd-tirofiban group howev er, the overall 6-month MACE rates were similar in both groups. There was a con siderable cost-saving with the use of hd-tirofiban. A prospective randomized t rial of hd-tirofiban vs. abciximab is warranted. Background: The TARGET study has been criticized for suboptimal platelet inhibition ition with tirofiban. We aimed to compare a high-dose bolus regimen of tirofiban (hd-tirofiban) to standard dose of abciximab for patients undergoing percutaneous coronary intervention (PCI). Methods: We assessed consecutive patients who re ceived either hd-tirofiban (25 mcg / kg bolus followed by 0.15 mcg / kg / min infusion for 18 h) or standard dose abciximab. In-hospital and 6-month outcomes were o btained in all Both hd -tirofiban and abciximab groups had acute coronary syndromes in 86% and 80% and diabetes in 10% of patients who had receiv ed hd-tirofiban were compared with 110 patients who had abciximab. Thrombocytopenia (platelet count <100,000) developed in 0.9% of patients receiving hd-tirofiban and 2% of patients receiving abciximab (p = 0.566 Bleeding requiring transfusion occurred in 7 . Peri-procedural troponin rise was 0.9% in patients receiving hd -tirofiban and 5.5% in patients receiving abciximab (p = 0.07). MACE (Myocardial in farction, Stroke , Revascularisation and Death) at 6 months was 23% in the hd-ti rofiban group and 20% in the abciximab group (p = 0.711). The pharmaceutical costs were AUD 322 for hd-tirofiban (one ampoule) and AUD 1350 for abciximab (3 ampoule s). Conclusion: There was a small increase in bleeding requiring transfusion and a lower rate of peri-procedural troponin rise in the hd-tirofiban group howev er, the overall 6-month MACE rates were similar in both groups. was a con siderable cost-saving with the use of hd-tirofiban. A prospective randomized t rial of hd-tirofiban vs. abciximab is warranted.