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Early abciximab adm...
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Rakowski, TomaszJagiellonian University
(author)
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
- Article/chapterEnglish2009
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Elsevier BV,2009
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LIBRIS-ID:oai:DiVA.org:liu-51402
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-51402URI
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https://doi.org/10.1016/j.ahj.2009.08.008DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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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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Siudak, ZbigniewJagiellonian University
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Dziewierz, ArturJagiellonian University
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Birkemeyer, RalfSchwarzwald Baar Klinikum Villingen Schwenningen
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Legutko, JacekJagiellonian University
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Mielecki, WaldemarJagiellonian University
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Depukat, RafalJagiellonian University
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Janzon, MagnusÖstergötlands Läns Landsting,Linköpings universitet,Kardiologi,Hälsouniversitetet,Kardiologiska kliniken(Swepub:liu)magja75
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Stefaniak, JustynaKrakow Cardiovasc Research Institute
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Zmudka, KrzysztofJagiellonian University
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Dubiel, Jacek SJagiellonian University
(author)
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Partyka, LukaszKrakow Cardiovasc Research Institute
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Dudek, DariuszJagiellonian University
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Jagiellonian UniversitySchwarzwald Baar Klinikum Villingen Schwenningen
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In:AMERICAN HEART JOURNAL: Elsevier BV158:4, s. 569-5750002-8703
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Rakowski, Tomasz
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Siudak, Zbigniew
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Dziewierz, Artur
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Birkemeyer, Ralf
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Legutko, Jacek
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Mielecki, Waldem ...
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Depukat, Rafal
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Janzon, Magnus
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Stefaniak, Justy ...
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Zmudka, Krzyszto ...
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Dubiel, Jacek S
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Partyka, Lukasz
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Dudek, Dariusz
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AMERICAN HEART J ...
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Linköping University