Document Detail


Recurrent ischemia during continuous 12-lead ECG-ischemia monitoring in patients with acute coronary syndromes treated with eptifibatide: relation with death and myocardial infarction. PURSUIT ECG-Ischemia Monitoring Substudy Investigators. Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.
MedLine Citation:
PMID:  10819406     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Computer-assisted continuous monitoring of the ST-segment allows detection and quantification of recurrent ischemia in patients with acute coronary syndromes. In a substudy of the PURSUIT (Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy) trial, this technique was used to evaluate the effects of the glycoprotein IIb/IIIa inhibitor eptifibatide on the incidence and severity of recurrent ischemia, and to investigate the relationship between recurrent ischemia and the occurrence of subsequent death or myocardial (re)infarction. A total of 258 patients with unstable angina or evolving myocardial infarction without ST elevation were monitored for 24 hours during infusion with either eptifibatide or placebo with a computer-assisted 12-lead ECG-ischemia monitoring device. Recurrent ischemic episodes were identified by an automated computer algorithm. Two hundred and sixteen patients (84%) had ECG recordings suitable for analysis. Ischemic episodes were detected in 35 (33%) of the 105 eptifibatide patients and in 32 (29%) of the 111 placebo patients (not significant). No difference in ischemic burden was apparent between both treatment groups. Patients who exhibited 2 or more episodes of recurrent ischemia more frequently died or suffered a myocardial infarction, both at 7 and 30 days, as well as through the 6-month follow-up. A greater ischemic burden was significantly related to adverse outcome during the 6-month follow-up period. Real-time computer-assisted continuous multilead ECG-ischemia monitoring may help to identify patients with unstable coronary syndromes at increased risk of adverse outcome and, thus, allow for better prognostic triage and more appropriate selection of therapeutic strategies. Integration of these systems in coronary care units and emergency wards should, therefore, be recommended.
Authors:
K M Akkerhuis; A C Maas; P A Klootwijk; M W Krucoff; S Meij; R M Califf; M L Simoons
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  33     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-07-20     Completed Date:  2000-07-20     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  127-36     Citation Subset:  IM    
Affiliation:
Thoraxcenter, Erasmus University and University Hospital Rotterdam, Rotterdam, The Netherlands. makkerhuis@cardialysis.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina, Unstable / complications,  diagnosis
Electrocardiography*
Female
Humans
Male
Middle Aged
Models, Statistical
Monitoring, Physiologic*
Myocardial Infarction / complications,  diagnosis,  mortality
Myocardial Ischemia / complications,  diagnosis*,  drug therapy
Peptides / therapeutic use*
Platelet Aggregation Inhibitors / therapeutic use*
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Recurrence
Signal Processing, Computer-Assisted
Chemical
Reg. No./Substance:
0/Peptides; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; 0/eptifibatide

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


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