Upstream vs Deferred Administration of Small-Molecule Glycoprotein IIb/IIIa Inhibitors in Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction - Insights From Randomized Clinical Trials -

DOI Web Site 被引用文献2件 参考文献67件
  • Dong Lili
    Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University
  • Zhang Feng
    Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University
  • Shu Xianhong
    Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University

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タイトル別名
  • – Insights From Randomized Clinical Trials –

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Background: Recent data have demonstrated similar outcomes for patients with ST-segment elevation myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) and are treated with small-molecule glycoprotein IIb/IIIa inhibitors (smGPIs) compared with those treated with abciximab. In the present study, a meta-analysis was performed to evaluate the relative safety and efficacy of upstream vs deferred administration of smGPIs in STEMI patients. Methods and Results: A total of 10 randomized clinical trials comparing upstream vs deferred administration of smGPIs in 2,724 patients were located in the electronic databases of the published literature. Preprocedural Thrombolysis In Myocardial Infarction Study (TIMI) grade 2 or 3 flow was present in 45.0% of the upstream group compared with 36.9% in the deferred group (odds ratio (OR) 1.40, P<0.001). However, no difference in post-procedural TIMI 3 flow (OR 0.87, P=0.25) was found between the groups. The 30-day mortality rate in the upstream group did not differ from that of the deferred group (OR 1.04, P=0.85). No significant difference was noted with respect to major bleeding complications (OR 1.25, P=0.38). Conclusions: In STEMI patients scheduled for primary PCI, although early smGPIs treatment improved initial epicardial patency, no beneficial effect on post-procedural angiographic or 30-day clinical outcome was found. Thus, the current available data do not support the routine utilization of upstream smGPIs in STEMI patients treated with primary PCI.  (Circ J 2010; 74: 1617 - 1624)<br>

収録刊行物

  • Circulation Journal

    Circulation Journal 74 (8), 1617-1624, 2010

    一般社団法人 日本循環器学会

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