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.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
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

Johanson, Per,1963Gothenburg University,Göteborgs universitet,Hjärt-kärlinstitutionen,Cardiovascular Institute(Swepub:gu)xjpert (författare)
Green, C. L. (författare)
Crater, S. W. (författare)
Roe, M. T. (författare)
Langer, A. (författare)
Giugliano, R. P. (författare)
Lincoff, A. M. (författare)
Newby, L. K. (författare)
Harrington, R. A. (författare)
Topol, E. J. (författare)
Califf, R. M. (författare)
Wagner, G. S. (författare)
Krucoff, M. W. (författare)
Göteborgs universitetHjärt-kärlinstitutionen (creator_code:org_t)

Av författaren/redakt...: Rebeiz, A. G.; Johanson, Per, 1 ...; Green, C. L.; Crater, S. W.; Roe, M. T.; Langer, A.; visa fler...; Giugliano, R. P.; Lincoff, A. M.; Newby, L. K.; Harrington, R. A ...; Topol, E. J.; Califf, R. M.; Wagner, G. S.; Krucoff, M. W.; visa färre...

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