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  • Title: Early abciximab use in ST-elevation myocardial infarction treated with primary percutaneous coronary intervention improves long-term outcome. Data from EUROTRANSFER Registry.
    Author: Siudak Z, Rakowski T, Dziewierz A, Janzon M, Birkemeyer R, Stefaniak J, Partyka Ł, Zmudka K, Dudek D.
    Journal: Kardiol Pol; 2010 May; 68(5):539-43. PubMed ID: 20491016.
    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 abciximab (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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