Document Detail


Glycoprotein IIb/IIIa receptor blockade improves outcomes in diabetic patients presenting with unstable angina/non-ST-elevation myocardial infarction: results from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study.
MedLine Citation:
PMID:  11076818     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Diabetic patients who present with unstable angina or non-ST-elevation myocardial infarction suffer a substantially greater incidence of subsequent infarction or death compared with nondiabetic patients. The present study was undertaken to examine whether diabetic patients in the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) study appeared to benefit from platelet glycoprotein IIb/IIIa receptor-mediated inhibition of platelet aggregation by tirofiban. METHODS AND RESULTS: Of the 1570 PRISM-PLUS patients treated with either tirofiban plus heparin (n=773) or heparin alone (n=797), approximately 23% in each treatment group were diabetic. A comparison of treatment outcomes in the diabetic subgroup revealed that the combination therapy compared with heparin alone was associated with reductions in the incidence of the composite primary end point of death, myocardial infarction (MI), or refractory ischemia at 2, 7, 30, and 180 days (7.7% versus 8.3%, 14. 8% versus 21.8%, 20.1% versus 29.0%, and 32.0% versus 39.9%, respectively; P=NS) and in the incidence of MI or death (0.0% versus 3.1%, P:=0.03; 1.2% versus 9.3%, P:=0.005; 4.7% versus 15.5%, P:=0. 002; and 11.2% versus 19.2%, P:=0.03). Tests for quantitative interaction between tirofiban therapy and diabetic status were significant. CONCLUSIONS: The addition of tirofiban to heparin and aspirin appears effective in the prevention of major ischemic events, particularly MI or death, in diabetic patients presenting with unstable angina and non-ST-elevation MI.
Authors:
P Théroux; J Alexander; C Pharand; E Barr; S Snapinn; A F Ghannam; F L Sax
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Circulation     Volume:  102     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-11-17     Completed Date:  2000-12-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2466-72     Citation Subset:  IM    
Affiliation:
Montreal Heart Institute, Montreal, Canada. theroux@ICM.UMontreal.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina, Unstable / complications,  drug therapy*
Anticoagulants / administration & dosage
Aspirin / therapeutic use
Diabetes Complications*
Disease Progression
Double-Blind Method
Drug Administration Schedule
Drug Therapy, Combination
Female
Heparin / administration & dosage*,  adverse effects
Humans
Infusions, Intravenous
Likelihood Functions
Male
Middle Aged
Myocardial Infarction / complications,  drug therapy*
Platelet Aggregation Inhibitors / administration & dosage
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Proportional Hazards Models
Survival Analysis
Treatment Outcome
Tyrosine / administration & dosage*,  adverse effects,  analogs & derivatives*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 144494-65-5/tirofiban; 50-78-2/Aspirin; 55520-40-6/Tyrosine; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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