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Titolo:
USE OF A MONOCLONAL-ANTIBODY DIRECTED AGAINST THE PLATELET GLYCOPROTEIN IIB IIIA RECEPTOR IN HIGH-RISK CORONARY ANGIOPLASTY/
Autore:
CALIFF RM; SHADOFF N; VALETT N; BATES E; GALEANA A; KNOPF W; SHAFTEL J; BENDER MJ; AVERSANO T; RAQUENO J; GURBEL P; COWFER J; COHEN M; CROSS P; BITTL J; EDDINGS K; TAYLOR M; DEROSA K; HATTEL L; COOPER L; ESHELMAN B; FINTEL D; NIEMYSKI P; KLEIN L; KENNEDY H; THORNTON T; KEREIAKES D; MARTIN L; ANDERSON L; HIGBY N; ELLIS S; BREZINA K; GEORGE B; CHAPEKIS A; SMITH D; ANWAR A; GERBER TL; PRITCHARD GL; MYLER R; SHAW R; MURPHY M; WARD K; MADIGAN NP; BLANKENSHIP J; HALBERT M; FLANAGAN C; TANNENBAUM M; POLICH M; STEVENSON C; TCHENG J; HOFFMAN S; MOORE RM; SMITH J; HENRY P; MCDONOUGH TJ; WESZT S; BRODIE B; MUNCY D; KLEIMAN N; TRAINOR K; ROSE D; JOHNSON S; WILLERSON J; FERGUSON JJ; HARLAN M; BASS TA; ROHMAN G; BROWNE K; CIESLA C; WORLEY S; TUZI J; HETTLEMAN B; BURKE WC; OLSEN G; KENNEDY SJ; TALLEY JD; YUSSMAN ZA; RAWERT M; GRASSMAN ED; WRONA L; SAMAHA J; EHEMANN B; BLEICH SD; LEONHARD R; CUMMINS F; NONNWEILER J; SANZ M; MAYER D; CLEMAN MW; PASCALE VJ; MCCONNELL S; DELCORE M; STENGEL L; IVANHOE RJ; GRANGER N; ROSENBERG MJ; SCHAECHTER A; AYCOCK G; WILCOX T; GOTTLIEB R; HUNTER H; UNTERECKER W; HART B; HEUSER R; HOOPMANN S; HANOVICH G; ANTOLICK A; GACIOCH G; CHIODO V; KARSKI K; TIMMIS G; SAFIAN M; AGUIRRE F; STONNER T; TAYLOR GJ; WOMACK K; RUYLE B; KRAUTHAMER D; WELCOM G; WESTON M; DILLON K; FRENCH WJ; REYNOLDS GT; NAVETTA F; MURPHY G; LEBOEUF R; SPENCER S; POPMA JJ; SWEET L; TOPOL EJ; SMITH CR; WEISMAN H; LEE KL; MILLER J; SIGMON K; TCHENG J; LEE KL; LUI M; KOSLOFF A; DIFULVIO J; WANG AL; ANDERSON K; WEISMAN H; DANN R; KINGMA W; NORTON D; MYER B; MASEK R; LEWANDOWSKI M; BRODERICK S; MUSCO M; SCHORR M; HARTMAN P; MCCARDLE L; FAXON D; ARMSTRONG P; GORE J; LOSCALZO J; MCCULLOUGH L; VERTER J; MARK DB; DAVIDSONRAY L; CLAPPCHANNING N; LAM LC; WAUGH RA; MCCANTS CB; HINDMAN MC; DEHMER G; HILLEGASS WB; FRID DJ; FORTIN DF; BROTT BC; FOREST TL; UNKS DM; HAMER ME; WAGNER GS; GATES K; SANE D;
Indirizzi:
DUKE UNIV,MED CTR,DEPT MED,DIV CARDIOL,BOX 31123 DURHAM NC 27710 PRESBYTERIAN HOSP ALBUQUERQUE NM 00000 UNIV MICHIGAN,MED CTR ANN ARBOR MI 48109 ST JOSEPH HOSP ATLANTA GA 00000 JOHNS HOPKINS UNIV HOSP BALTIMORE MD 21205 UNIV MARYLAND HOSP BALTIMORE MD 21201 ST FRANCIS HOSP BEECH GROVE IN 00000 BRIGHAM & WOMENS HOSP BOSTON MA 02115 DEBORAH HEART & LUNG CTR BROWNS MILLS NJ 08015 DEPAUL HOSP CHEYENNE WY 00000 NORTHWESTERN UNIV CHICAGO IL 60611 RUSH PRESBYTERIAN ST LUKES MED CTR CHICAGO IL 60612 CHRIST HOSP CINCINNATI OH 45219 CLEVELAND CLIN CLEVELAND OH 44106 METHODISTS HOSP COLUMBUS OH 00000 BAYLOR UNIV DALLAS TX 00000 SAN FRANCISCO HEART INST DALY CITY CA 00000 GEISINGER MED CTR DANVILLE PA 17822 MERCY HOSP,IOWA HEART CTR DES MOINES IA 00000 DUKE UNIV DURHAM NC 27706 ST VINCENT HLTH CTR ERIE PA 00000 EVANSTON HOSP CORP EVANSTON IL 60201 MOSES CONE HOSP GREENSBORO NC 00000 BAYLOR UNIV,METHODIST BEN TAUB GEN HOSP HOUSTON TX 00000 TEXAS HEART INST HOUSTON TX 77025 UNIV FLORIDA,MED CTR JACKSONVILLE FL 00000 LAKELAND GEN HOSP LAKELAND FL 00000 LANCASTER GEN HOSP LANCASTER PA 00000 HITCHCOCK MED CTR LEBANON NH 00000 UNIV LOUISVILLE LOUISVILLE KY 40292 LOYOLA UNIV HOSP MAYWOOD IL 00000 BAPTIST MEM HOSP MEMPHIS TN 38146 E JEFFERSON HOSP METAIRIE LA 00000 ST LUKES HOSP MILWAUKEE WI 00000 ST PATRICKS HOSP MISSOULA MT 00000 YALE UNIV,MED CTR NEW HAVEN CT 06520 CREIGHTON UNIV,CTR CARDIAC OMAHA NE 68178 FLORIDA HOSP ORLANDO FL 00000 LUTHERAN GEN HOSP PARK RIDGE IL 60068 SACRED HEART PENSACOLA FL 00000 GRAD HOSP PHILADELPHIA PHILADELPHIA PA 19146 PHILADELPHIA HEART INST PHILADELPHIA PA 00000 ARIZONA HEART INST & FDN PHOENIX AZ 00000 N MEM MED CTR ROBBINSDALE MN 00000 ROCHESTER GEN HOSP ROCHESTER NY 14621 WILLIAM BEAUMONT HOSP ROYAL OAK MI 48072 ST LOUIS UNIV ST LOUIS MO 63103 ST JOHNS HOSP SPRINGFIELD IL 00000 S MIAMI HOSP MIAMI FL 00000 TAMPA GEN HOSP TAMPA FL 33606 UCLA,HARBOR MED CTR TORRANCE CA 00000 MOTHER FRANCES HOSP TYLER TX 00000 WASHINGTON HOSP CTR WASHINGTON DC 20010
Titolo Testata:
The New England journal of medicine
fascicolo: 14, volume: 330, anno: 1994,
pagine: 956 - 961
SICI:
0028-4793(1994)330:14<956:UOAMDA>2.0.ZU;2-2
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACTIVATED CLOTTING TIME; CREATINE KINASE-MB; MYOCARDIAL-INFARCTION; THROMBOLYTIC THERAPY; TASK-FORCE; DIPYRIDAMOLE; TRANSFUSION; PREDICTORS; PREVENTION; INFECTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
37
Recensione:
Indirizzi per estratti:
Citazione:
R.M. Califf et al., "USE OF A MONOCLONAL-ANTIBODY DIRECTED AGAINST THE PLATELET GLYCOPROTEIN IIB IIIA RECEPTOR IN HIGH-RISK CORONARY ANGIOPLASTY/", The New England journal of medicine, 330(14), 1994, pp. 956-961

Abstract

Background. Platelets are believed to play a part in the ischemic complications of coronary angioplasty, such as abrupt closure of the coronary vessel during or soon after the procedure. Accordingly, we evaluated the effect of a chimeric monoclonal-antibody Fab fragment (c7E3 Fab) directed against the platelet glycoprotein IIb/IIIa receptor, in patients undergoing angioplasty who were at high risk for ischemic complications. This receptor is the final common pathway for platelet aggregation. Methods. In a prospective, randomized, double-blind trial, 2099 patients treated at 56 centers received a bolus and an infusion of placebo, a bolus of c7E3 Fab and an infusion of placebo, or a bolus andan infusion of c7E3 Fab. They were scheduled to undergo coronary angioplasty or atherectomy in high-risk clinical situations involving severe unstable angina, evolving acute myocardial infarction, or high-riskcoronary morphologic characteristics. The primary study end point consisted of any of the following: death, nonfatal myocardial infarction,unplanned surgical revascularization, unplanned repeat percutaneous procedure, unplanned implantation of a coronary stent, or insertion of an intraaortic balloon pump for refractory ischemia. The numbers of end-point events were tabulated for 30 days after randomization. Results. As compared with placebo, the c7E3 Fab bolus and infusion resulted in a 35 percent reduction in the rate of the primary end point (12.8 vs. 8.3 percent, P = 0.008), whereas a 10 percent reduction was observedwith the c7E3 Fab bolus alone (12.8 vs. 11.5 percent, P = 0.43). The reduction in the number of events with the c7E3 Fab bolus and infusionwas consistent across the end points of unplanned revascularization procedures and nonfatal myocardial infarction. Bleeding episodes and transfusions were more frequent in the group given the c7E3 Fab bolus and infusion than in the other two groups. Conclusions. Ischemic complications of coronary angioplasty and atherectomy were reduced with a monoclonal antibody directed against the platelet IIb/IIIa glycoprotein receptor, although the risk of bleeding was increased.

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Documento generato il 22/09/20 alle ore 11:15:28