Document Detail


Routine upfront abciximab versus standard periprocedural therapy in patients undergoing primary percutaneous coronary intervention for cardiogenic shock: The PRAGUE-7 Study. An open randomized multicentre study.
MedLine Citation:
PMID:  21526919     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock.
METHODS: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure).
RESULTS: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 group B patients (27.5%, P = 0.24). Ejection fraction among survivors after 30 days was 44 ± 11% (A) versus 41 ± 12% (B, P = 0.205). Major bleeding occurred in 17.5% (A) versus 7.5% (B, P = 0.310). No differences (A versus B) were found in TIMI-flow and MBG after PCI.
CONCLUSIONS: This study did not show any benefit from routine pre-procedural abciximab when compared with a selective abciximab use during the intervention in patients with cardiogenic shock undergoing primary PCI. However, small sample size of the trial preclude any definitive conclusion, a larger prospective, randomized, multicentered trial is needed.
Authors:
Petr Tousek; Richard Rokyta; Jitka Tesarova; Radek Pudil; Jan Belohlavek; Josef Stasek; Filip Rohac; Petr Widimsky
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2011-04-28
Journal Detail:
Title:  Acute cardiac care     Volume:  13     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-08-31     Completed Date:  2012-01-09     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  116-22     Citation Subset:  IM    
Affiliation:
Cardiocenter, 3rd Faculty of Medicine, Charles University, University Hospital Vinohrady, Prague, Czech Republic. tousek@email.cz
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00420030
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon, Coronary / methods
Antibodies, Monoclonal / administration & dosage*
Czech Republic
Female
Humans
Immunoglobulin Fab Fragments / administration & dosage*
Male
Middle Aged
Myocardial Infarction / complications,  drug therapy*,  mortality,  pathology
Platelet Aggregation Inhibitors / administration & dosage
Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
Prospective Studies
Shock, Cardiogenic / complications,  drug therapy*,  mortality,  pathology
Stroke Volume
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; X85G7936GV/abciximab

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


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