Comparison of ST-segment resolution with combined fibrinolytic and glycoprotein IIb/IIIa inhibitor therapy versus fibrinolytic alone (data from four clinical trials)

• We compared combination fibrinolytic plus glycoprotein IIb/IIIa inhibitor therapy with stand-alone fibrinolysis with respect to speed and stability of reperfusion in patients who had acute ST-segment elevation myocardial infarction; data were obtained from 654 patients in 4 trials (Integrilin to Manage Platelet Aggregation to Combat Thrombosis in Acute Myocardial Infarction, Platelet Aggregation Receptor Antagonist Dose Investigation and Reperfusion Gain in Myocardial Infarction, Integrilin and Tenecteplase in Acute Myocardial Infarction, and the Fifth Global Use of Strategies to Open Occluded Coronary Arteries) that compared thrombolytics plus lamifiban, eptifibatide, or abciximab with standard thrombolysis. We found significantly faster and more stable ST-segment recovery with combination therapy starting at 60 minutes (56.7% vs 48.0% with >/=50% ST-segment resolution, p = 0.03) and sustained over 180 minutes after drug administration; this transient benefit may suggest a time frame when more optimal percutaneous coronary intervention can be performed.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Acetates/therapeutic use

Aged

Antibodies

Monoclonal/therapeutic use

Clinical Trials

Drug Therapy

Combination

Electrocardiography

Female

Humans

Immunoglobulin Fab Fragments/therapeutic use

Male

Middle Aged

Myocardial Infarction/*drug therapy/mortality

Peptides/therapeutic use

Platelet Aggregation Inhibitors/*therapeutic use

Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors

Streptokinase/therapeutic use

Survival Analysis

Thrombolytic Therapy/*methods

Tissue Plasminogen Activator/therapeutic use

Treatment Outcome

Tyrosine/*analogs & derivatives/therapeutic use

Publikations- och innehållstyp

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