| Prehospital abciximab in ST-segment elevation myocardial infarction: results of the randomized, double-blind MISTRAL study. | |
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MedLine Citation:
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PMID: 22319064 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The value of prehospital initiation of glycoprotein IIb/IIIa inhibitors remains a controversial issue. We sought to investigate whether in-ambulance initiation of abciximab in patients with ST-segment elevation myocardial infarction (STEMI) improves ST-segment elevation resolution (STR) after primary percutaneous coronary intervention (PCI). METHODS AND RESULTS: MISTRAL (Myocardial Infarction with ST-elevation Treated by Primary Percutaneous Intervention Facilitated by Early Reopro Administration in Alsace) is a prospective, randomized, double-blind study. Two hundred and fifty-six patients with acute STEMI were allocated to receive abciximab either in the ambulance (ambulance group, n=127) or in the catheterization laboratory (hospital group, n=129). The primary end point was complete (>70%) STR after PCI. Complete STR was not significantly different between the 2 groups (before PCI, 21.6% versus 15.5%, P=0.28; after PCI, 70.3% versus 65.8%, P=0.49). Thrombolysis In Myocardial Infarction (TIMI) 2 to 3 flow rates before PCI tended to be higher in the ambulance group (46.8% versus 35%, P=0.08) but not after PCI (70.3% versus 65.8%, P=0.49). Slow flow tended to be lower (5.6% versus 13.4%, P=0.07), and distal embolization occurred significantly less often in the ambulance group (8.1% versus 21.1%, P=0.008). One- and 6-month major adverse cardiac event rates were low and similar in both groups. CONCLUSIONS: Early ambulance administration of abciximab in STEMI did not improve either STR or TIMI flow rate after PCI. However, it tended to improve TIMI flow pre-PCI and decreased distal embolization during procedure. Larger studies are needed to confirm these results. |
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Authors:
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Patrick Ohlmann; Philippe Reydel; Laurent Jacquemin; Frédéric Adnet; Olivier Wolf; Jean-Claude Bartier; Anne Weiss; Frédéric Lapostolle; Cédric Gaultier; Emmanuel Salengro; Hakim Benamer; Philippe Guyon; Bernard Chevalier; Simon Catan; Patrick Ecollan; Tahar Chouihed; Michael Angioi; Michel Zupan; François Bronner; Pierre Bareiss; Gabriel Steg; Gilles Montalescot; Jean-Pierre Monassier; Olivier Morel |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2012-02-07 |
Journal Detail:
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Title: Circulation. Cardiovascular interventions Volume: 5 ISSN: 1941-7632 ISO Abbreviation: Circ Cardiovasc Interv Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-16 Completed Date: 2012-06-08 Revised Date: 2013-05-24 |
Medline Journal Info:
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Nlm Unique ID: 101499602 Medline TA: Circ Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 69-76, S1 Citation Subset: IM |
Affiliation:
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Pôle d'Activité Médico-Chirurgicale Cardiovasculaire and SAMU 67, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, France. patrick.ohlmann@chru-strasbourg.fr |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00638638 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon, Coronary* Antibodies, Monoclonal / administration & dosage*, adverse effects Anticoagulants / administration & dosage*, adverse effects Double-Blind Method Electrocardiography Emergency Medical Services* Female Humans Immunoglobulin Fab Fragments / administration & dosage*, adverse effects Male Middle Aged Myocardial Infarction / drug therapy*, physiopathology, surgery Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors Prospective Studies Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Anticoagulants; 0/Immunoglobulin Fab Fragments; 0/Platelet Glycoprotein GPIIb-IIIa Complex; X85G7936GV/abciximab |
| Comments/Corrections | |
Comment In:
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Nat Rev Cardiol. 2012 Apr;9(4):186
[PMID:
22371110
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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