Document Detail


Impact of early abciximab administration on myocardial reperfusion in patients with ST-segment elevation myocardial infarction pretreated with 600 mg of clopidogrel before percutaneous coronary intervention.
MedLine Citation:
PMID:  20373130     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Early rapid platelet inhibition with abciximab before primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is suggested as beneficial. In previous studies on early abciximab administration clopidogrel was administered in cathlab in low loading dose. We investigated the role of early abciximab administration on top of early clopidogrel 600 mg loading dose in patients with STEMI treated with PPCI. A total of 73 non-shock STEMI < 6 h patients admitted to remote hospitals with anticipated delay to PPCI < 90 min were randomly assigned to three study groups--24 pts received abciximab before transfer to cathlab (early = group EA), 27 in cathlab during PPCI (late = group LA) and in 22 abciximab administration was left to operator's discretion during PPCI (selective = SA; given in 22.7% of patients). All patients received clopidogrel (600 mg), aspirin and heparin (70 U/kg) before transfer to cathlab. Angiography revealed more frequent infarct-related artery patency (TIMI 2 + 3: EA vs LA vs SA: 45.8 vs 18.5 vs 13.6%, P = 0.024), better myocardial tissue perfusion (MBG 2 + 3: EA vs LA vs SA: 45.8 vs 14.8 vs 13.6%, P = 0.02) in EA group in baseline angiography. There was no difference in these angiographic parameters and ECG ST-segment resolution after PPCI. In multivariate analysis early abciximab administration was an independent predictor of infarct-related artery patency in baseline angiography (OR 6.5; 95% CI 1.83-23.1; P = 0.004). Early abciximab administration before transfer for PPCI in patients with STEMI pretreated with 600 mg of clopidogrel results in more frequent infarct-related artery patency and better myocardial tissue perfusion before PPCI.
Authors:
Dariusz Dudek; Tomasz Rakowski; Stanislaw Bartus; Dawid Giszterowicz; Wojciech Dobrowolski; Krzysztof Zmudka; Jaroslaw Zalewski; Andrzej Ochala; Pawel Wieja; Bogdan Janus; Artur Dziewierz; Jacek Legutko; Leszek Bryniarski; Jacek S Dubiel
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of thrombosis and thrombolysis     Volume:  30     ISSN:  1573-742X     ISO Abbreviation:  J. Thromb. Thrombolysis     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-02-02     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  9502018     Medline TA:  J Thromb Thrombolysis     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  347-53     Citation Subset:  IM    
Affiliation:
Department of Interventional Cardiology, Jagiellonian University Medical College, Kopernika 17 St, 31-501 Krakow, Poland. mcdudek@cyf-kr.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / methods*
Antibodies, Monoclonal / administration & dosage*
Anticoagulants
Female
Humans
Immunoglobulin Fab Fragments / administration & dosage*
Male
Middle Aged
Myocardial Infarction / drug therapy,  therapy*
Myocardial Reperfusion / methods*
Platelet Aggregation Inhibitors
Ticlopidine / administration & dosage,  analogs & derivatives*
Treatment Outcome
Vascular Patency / drug effects*
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Anticoagulants; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; X85G7936GV/abciximab

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


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