Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial

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Comparison of very early treatment with either fibrinolysis or percutaneous coronary intervention facilitated with abciximab with respect to ST recovery and infarct-related artery epicardial flow in patients with acute ST-segment elevation myocardial infarction: the Swedish Early Decision (SWEDES) reperfusion trial

Svensson, L. (författare): Karolinska Institutet

Aasa, M. (författare): Karolinska Institutet

Dellborg, Mikael, 1954 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine

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Gibson, C. M. (författare)

Kirtane, A. (författare)

Herlitz, Johan, 1949 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine,[external]

Ohlsson, A. (författare)

Karlsson, Thomas, 1956 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine

Grip, Lars, 1952 (författare): Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine

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(creator_code:org_t)

Mosby, Inc. 2006
2006
Engelska.
Ingår i: Am Heart J. - : Mosby, Inc.. - 1097-6744 .- 0002-8703. ; 151:4

Relaterad länk:: https://gup.ub.gu.se...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

BACKGROUND: Results from a number of studies indicate that primary percutaneous coronary intervention (PCI) is superior to fibrinolysis for treatment of acute ST-elevation myocardial infarction. Modern adjunctive antithrombotic treatment with systematic use of low-molecular-weight heparins, fibrin-specific thrombolysis, and glycoprotein IIb/IIIa receptor inhibitors may improve the outcome compared with what was achieved in previous studies. METHODS: Patients with ST-elevation myocardial infarction were randomized to receive enoxaparin followed by reteplase (group A; n = 104) or enoxaparin followed by abciximab and transfer to invasive center for optional PCI (group B; n = 101). Primary end points were ST-segment resolution 120 minutes and TIMI flow at coronary angiography 5 to 7 days after randomization. RESULTS: Forty-two percent of the patients started therapy in the prehospital phase. Time from symptom to treatment was 114 minutes in group A and 202 minutes in group B. Baseline characteristics were similar in the 2 groups. Sixty-four percent in group A and 68% in group B had ST resolution of > 50% at 120 minutes (not significant). At control angiography, 54% in the fibrinolytic group and 71% in the invasive group had TIMI 3 flow (P = .04). At 30 days, the composite of death, stroke, or reinfarction occurred in 8% in the fibrinolytic group compared with 3% in the invasive group (not significant). CONCLUSIONS: Despite much shorter time delay to start of fibrinolysis than PCI, this did not result in signs of superior myocardial reperfusion. Epicardial flow in the infarct-related artery was better after invasive therapy, and there was a trend toward better clinical outcome after this treatment compared with after fibrinolysis.

Nyckelord

Adult
Aged
*Angioplasty
Transluminal
Percutaneous Coronary
Antibodies
Monoclonal/*therapeutic use
Antifibrinolytic Agents/*therapeutic use
Coronary Angiography
Enoxaparin/*therapeutic use
Female
Humans
Immunoglobulin Fab Fragments/*therapeutic use
Male
Middle Aged
Myocardial Infarction/*drug therapy/radiography
Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
Regional Blood Flow
*Thrombolytic Therapy
Time Factors
Treatment Outcome

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Av författaren/redakt...: Svensson, L.; Aasa, M.; Dellborg, Mikael ...; Gibson, C. M.; Kirtane, A.; Herlitz, Johan, ...; visa fler...; Ohlsson, A.; Karlsson, Thomas ...; Grip, Lars, 1952; visa färre...

Artiklar i publikationen: Am Heart J

Av lärosätet: Göteborgs universitet; Högskolan i Borås; Karolinska Institutet

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