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- Dudek, Dariusz, et al.
(författare)
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European registry on patients with ST-elevation myocardial infarction transferred for mechanical reperfusion with a special focus an early administration of abciximab-EUROTRANSFER Registry
- 2008
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Ingår i: American Heart Journal. - : Elsevier BV. - 0002-8703 .- 1097-6744. ; 156:6, s. 1147-1154
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Tidskriftsartikel (refereegranskat)abstract
- Background: Abciximab is established as adjunct to primary percutaneous coronary intervention (PCI). Based on some smaller studies, ST-segment elevation myocardial infarction (STEMI) networks in various European countries have adopted the start of abciximab before transfer to the catheterization laboratory (cathlab) hospital as part of their routine treatment options. Although a recently published study did not reveal improved clinical outcome when starting abciximab before the cathlab, a potential benefit from such early administration, in particular in the setting of transfer networks, remains unclear and has been the subject of debate. Methods: Data of consecutive patients with STEMI transferred for primary PCI in hospital/ambulance-feeded STEMI networks treated between November 2005 and January 2007 at 15 PCI centers from 7 European countries were collected in the web-based EUROTRANSFER Registry. Results: Data from a total of 1,650 patients were collected. Abciximab was administered to 1086 patients (66%), of whom 727 received early abciximab (EA group: abciximab started before admission to cathlab, at least 30 minutes before balloon). Another 359 patients received late abciximab (LA group: periprocedural administration of abciximab in the cathlab). Preprocedural TIMI 3 flow was observed in 17.7% of patients with EA and in 8.9% in the LA group (P < .0001). Thirty-day mortality was 3.9% in the EA group versus 7.5% with LA (OR 0.49, 95% CI 0.29-0.85, P = .011), and composite 30-day outcome including death, repeated myocardial infarction, and urgent revascularization was present in 5.5% and 10.3%, respectively (OR 0.5 1, 95% CI 0.32-0.81, P = .004). These differences remain statistically significant in favor of early abciximab after accounting and adjustment for differences between the groups by means of a multivariate regression model and propensity score. Conclusions: Patients in STEMI networks transferred for primary PCI who have received abciximab before transfer rather than in the cathlab had more patent arteries before PCI and showed lower rates for death and the composite clinical outcome at 30-day follow-up.
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- Legutko, Jacek, et al.
(författare)
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Similar outcome of ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention regardless of presence of cardiac surgery on-site.
- 2014
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Ingår i: Kardiologia polska. - : Polskie Towarzystwo Kardiologiczne. - 0022-9032 .- 1897-4279. ; 72:10, s. 949-53
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The growing penetration of mechanical reperfusion in ST-elevation myocardial infarction (STEMI) has been achieved by the creation of new percutaneous coronary intervention (PCI) centres which have helped to shorten delays but have compromised PCI volumes.AIM: To compare the outcomes in STEMI patients treated in PCI centres with or without surgical back-up.METHODS: Data concerning 1,650 registry patients was analysed. The analysis was based on cathlab classification with cardiac surgery on site (n = 996) and without (n = 654).RESULTS: There was a 0.3% rate of transfer (two patients out of 654) for urgent coronary artery bypass grafting from PCI centres without cardiac surgery on site. There were no differences in in-hospital and long-term mortality in patients in both studied groups.CONCLUSIONS: No differences in short and long-term outcomes were noticed for STEMI patients treated in centres with or without cardiac surgery on-site.
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- Rakowski, Tomasz, et al.
(författare)
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Early abciximab administration before transfer for primary percutaneous coronary interventions for ST-elevation myocardial infarction reduces 1-year mortality in patients with high-risk profile. Results from EUROTRANSFER Registry
- 2009
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Ingår i: AMERICAN HEART JOURNAL. - : Elsevier BV. - 0002-8703. ; 158:4, s. 569-575
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Tidskriftsartikel (refereegranskat)abstract
- Background There are conflicting data on the clinical benefit from early administration of abciximab from a large randomized trial and a registry. However, both sources suggest that a benefit may depend on the baseline risk profile of the patients. We evaluated the role of early abciximab administration in patients with ST-segment-elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention stratified by the STEMI Thrombolysis In Myocardial Infarction (TIMI) risk score. Methods A total of 1,650 patients were enrolled into the EUROTRANSFER Registry. One thousand eighty-six patients received abciximab (66%). Abciximab was administered early in 727 patients (EA) and late in 359 patients (LA). We used the TIMI risk score for risk stratification. Patients with scores 3 constituted the high-risk group of 616 patients (56.7%), whereas 470 patients formed the low-risk cohort. Factoring in the timing of the abciximab administration resulted in 4 groups of patients who were compared for mortality at 1 year: EA/high-risk (n = 413); LA/high-risk (n = 203); EA/low-risk (n = 3 14); LA/low-risk (n = 156). Baseline difference was accounted for by means of propensity score. Results In high-risk patients, 1-year mortality was significantly lower with early abcximab compared to late administration (8.7% vs 15.8%; odds ratio 0.51, CI 0.31-0.85, P = .01). In multivariable Cox regression analysis, both early abciximab administration and patients risk profile (TIMI score :3) were identified as independent predictors of 1-year mortality. Conclusions Early abciximab administration before transfer for percutaneous coronary intervention in STEMI shows lower mortality at 1-year follow-up. This effect is confined to patients with higher risk profile as defined by TIMI risk score andgt;= 3.
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- Rakowski, Tomasz, et al.
(författare)
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Impact of infarct related artery patency after early abciximab administration on one-year mortality in patients with ST-segment elevation myocardial infarction (data from the EUROTRANSFER Registry)
- 2012
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Ingår i: Kardiologia polska. - : Polskie Towarzystwo Kardiologiczne. - 0022-9032 .- 1897-4279. ; 70:3, s. 215-221
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Tidskriftsartikel (refereegranskat)abstract
- Background: Spontaneous early infarct related artery (IRA) recanalisation before primary percutaneous coronary intervention (pPCI) has a favourable impact on outcome. However, the role played by pharmacotherapy driven patency prior to pPCI is still a matter of debate. less thanbrgreater than less thanbrgreater thanAim: To assess the role of early IRA patency (TIMI flow 2 or 3) after early abciximab administration in patients with ST-segment elevation myocardial infarction (STEM!) transferred for pPCI. less thanbrgreater than less thanbrgreater thanMethods: Data was gathered for 1,650 consecutive sTEMI patients transferred for pPCI from hospital networks in seven countries in Europe between November 2005 and January 2007. We identified 691 patients who were pretreated with abciximab before transportation to a cathlab hospital and underwent PCI. less thanbrgreater than less thanbrgreater thanResults: Angiography showed early IRA patency (TIMI flow 2 or 3) in 233 (33.7%) patients, and occluded IRA (TIMI flow 0 or 1) in 458 (66.3%) patients. In patients with patent IRA, in baseline angiography the rate of TIMI 3 flow and ECG ST-segment resolution andgt; 50% after PCI was higher compared to patients with occluded IRA. One year mortality was significantly lower in patients with patent IRA, 1.3% vs 7% (OR 0.17; CI 0.05-0.6; p = 0.001). In multivariable Cox regression analysis, IRA patency at baseline was identified as an independent predictor of one-year mortality. less thanbrgreater than less thanbrgreater thanConclusions: Infarct related artery recanalisation after early pharmacological pretreatment in STEMI patients undergoing transportation for pPCI is associated with better post-procedural myocardial perfusion and lower one-year mortality.
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- Siudak, Zbigniew, et al.
(författare)
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Early abciximab use in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention improves long-term outcome. Data from EUROTRANSFER Registry
- 2010
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Ingår i: KARDIOLOGIA POLSKA. - : Polish Cardiac Society / TERMEDIA. - 0022-9032. ; 68:5, s. 539-545
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Tidskriftsartikel (refereegranskat)abstract
- Background: Primary percutaneous coronary intervention (PCI) is the preferred method of reperfusion in patients with ST elevation myocardial infarction (STEMI). Abciximab is a well established adjunct to primary PCI. The proper timing of abciximab administration in STEMI patients has been investigated in randomised trials, registries and metanalysis, providing conflicting results. Methods: Consecutive data on STEMI patients, transferred for primary PCI in hospital/ambulance STEMI networks between November 2005 and January 2007, from 15 PCI centres in seven European countries was gathered together for a one-year long-term clinical observation (93% rate of completeness). Results: Data from 1,650 patients was collected in the EUROTRANSFER Registry. Abciximab was administered to 1,086 patients (66%), 727 patients received early (at least 30 minutes prior to first balloon inflation) abciximab (EA), and another 359 patients received late abcixirnab (LA). One year mortality was 5.8% in the EA group vs 10.3% with LA (p = 0.007). Adjustment for propensity score methods for EA administration did not change the results, still providing a favourable outcome for the EA group (p = 0.004). It was also revealed that only a minority of patients (36%) were treated within the 90-minute recommended time window from first medical contact to PCI (and 60% for the 120-min time delay). Conclusions: Patients transferred for primary PCI in STEMI hospital networks showed lower rates of death in long-term one-year clinical follow-up when treatment with abciximab was started early.
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