Document Detail

Myocardial salvage after coronary stenting plus abciximab versus fibrinolysis plus abciximab in patients with acute myocardial infarction: a randomised trial.
MedLine Citation:
PMID:  11918909     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with acute myocardial infarction might benefit from the addition of glycoprotein IIb/IIIa inhibitors to fibrinolytic or mechanical reperfusion strategies. We compared two strategies, stenting and fibrinolysis, both combined with abciximab, in terms of their ability to salvage myocardium in patients with acute myocardial infarction.
METHODS: We enrolled 162 patients with acute myocardial infarction within 12 h of onset of symptoms, assigning 81 stenting plus abciximab and 81 alteplase plus abciximab. Technetium-99m sestamibi scintigraphy was done at admission and after a median of 11 days to calculate initial perfusion defect, final infarct size, and degree of myocardial salvage. The primary endpoint was the salvage index (the ratio of the degree of myocardial salvage to the initial perfusion defect). Major adverse clinical events within 6 months from randomisation were also compared between the two treatments.
FINDINGS: Paired scintigraphic measurements were available for 70 patients in the stent group and 71 in the alteplase group. Stenting was associated with greater myocardial salvage than alteplase (median 13.6% [IQR 5.9-23.9] vs 8.0% [2.5-16.0] of the left ventricle; p=0.007). Salvage index was greater in the stent group than in the alteplase group (median 0.60 [0.37-0.82] vs 0.41 [0.13-0.58]; p=0.001). The 6-month mortality rate was 5% (four deaths) in the stent group and 9% (seven deaths) in the alteplase group (relative risk 0.56 [95% CI 0.17-1.88]; p=0.35).
INTERPRETATION: In patients with acute myocardial infarction, a reperfusion strategy based on stenting with abciximab produced more myocardial salvage than the combination of fibrinolysis plus abciximab. Larger studies are needed to assess whether these effects translate into clinical benefit.
Adnan Kastrati; Julinda Mehilli; Josef Dirschinger; Ullrich Schricke; Jodi Neverve; Jürgen Pache; Stefan Martinoff; Franz Josef Neumann; Stephan Nekolla; Rudolf Blasini; Melchior Seyfarth; Markus Schwaiger; Albert Schömig;
Related Documents :
15774249 - Reoperation, myocardial infarction and mortality after transurethral and open prostatec...
9183039 - Coronary stenting with ave microstents in acute myocardial infarction.
15512379 - The efficiency of hysterosalpingo-contrastsonography (hycosy) in the evaluation of tuba...
14523139 - Sirolimus-eluting stents versus standard stents in patients with stenosis in a native c...
12112879 - Acute and six-month clinical outcome after helistent stent implantation in coronary art...
16263349 - Short- and long-term outcomes of the titanium-no stent registry.
9364279 - Left ventricular geometry in presenting untreated hypertension.
6730889 - Effects of colchicine on the formation and looping of the tubular heart of the embryoni...
15248819 - The influence of testosterone upon vascular reactivity.
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  359     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-28     Completed Date:  2002-04-09     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  England    
Other Details:
Languages:  eng     Pagination:  920-5     Citation Subset:  AIM; IM    
Deutsches Herzzentrum, Technische Universität, Munich, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Antibodies, Monoclonal / therapeutic use*
Immunoglobulin Fab Fragments / therapeutic use*
Middle Aged
Myocardial Infarction / drug therapy*,  radionuclide imaging,  therapy
Salvage Therapy / methods
Treatment Outcome
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; X85G7936GV/abciximab

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

Previous Document:  Long-term effects of mammography screening: updated overview of the Swedish randomised trials.
Next Document:  Relation between use of angiotensin-converting enzyme inhibitors and muscle strength and physical fu...