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- Dziewierz, Artur, et al.
(författare)
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Early abciximab administration before primary percutaneous coronary intervention improves clinical outcome in elderly patients transferred with ST-elevation myocardial infarction Data from the EUROTRANSFER registry
- 2010
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Ingår i: INTERNATIONAL JOURNAL OF CARDIOLOGY. - : Elsevier Science B.V., Amsterdam.. - 0167-5273. ; 143:2, s. 147-153
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited data are available concerning benefits and risks of early abciximab (EA) administration before primary percutaneous coronary intervention (PPCI) in elderly ST-segment elevation myocardial infarction (STEMI) patients. The objective of the study was to assess the impact of EA before PPCI in elderly (andgt;= 65 years) patients. Methods and results: We identified 545 patients andlt;65 years (354 with EA administration (andgt;30 min before PPCI), 191 late abciximab (LA)), and 541 patients andgt;= 65 years of age (373 EA, 168 LA) in the EUROTRANSFER Registry database. Elderly patients were more likely to have comorbidities, angiographic PCI complications, and bleeding events. EA promotes infarct-related artery patency before PPCI and improves myocardial reperfusion after PPCI in both age groups, but the risk of 30-day death (EA vs. LA: andlt;65 years, 2.0% vs. 1.6%; p = 0.999; andgt;= 65 years, 5.9% vs. 14.3%; p = 0.001) and 30-day death + reinfarction (EA vs. LA: andlt;65 years, 2.5% vs. 2.1%; p = 0.999; andgt;= 65 years, 7.5% vs. 17.3%; p = 0.001) was reduced in elderly patients only. There was no difference in bleedings, especially major bleedings requiring transfusion (EA vs. LA: patients andlt;65 years, 2.3% vs. 0%, p = 0.055; andgt;= 65 years, 2.4% vs. 3%; p = 0.448) between groups. Conclusions: Patients andgt;= 65 years of age have a substantially increased risk of angiographic PCI complications, death and bleeding events compared with their younger counterparts. Strategy of EA before PPCI improves reperfusion parameters and clinical outcome in elderly patients and is not associated with elevated risk of major bleeding.
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| 2. |
- 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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