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Titolo:
Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention - Results of the GOLD (AU-Assessing Ultegra) multicenter study
Autore:
Steinhubl, SR; Talley, JD; Braden, GA; Tcheng, JE; Casterella, PJ; Moliterno, DJ; Navetta, FI; Berger, PB; Popma, JJ; Dangas, G; Gallo, R; Sane, DC; Saucedo, JF; Jia, G; Lincoff, AM; Theroux, P; Holmes, DR; Teirstein, PS; Kereiakes, DJ;
Indirizzi:
Wilford Hall USAF Med Ctr, Dept Cardiol, Lackland AFB, TX 78236 USA Wilford Hall USAF Med Ctr Lackland AFB TX USA 78236 and AFB, TX 78236 USA Univ Arkansas, Little Rock, AR 72204 USA Univ Arkansas Little Rock AR USA72204 rkansas, Little Rock, AR 72204 USA Carl & Edyth Lindner Res Ctr Clin Cardiovasc Res, Cincinnati, OH USA Carl & Edyth Lindner Res Ctr Clin Cardiovasc Res Cincinnati OH USA H USA Wake Forest Univ, Bowman Gray Sch Med, Winston Salem, NC USA Wake Forest Univ Winston Salem NC USA ray Sch Med, Winston Salem, NC USA Duke Clin Res Inst, Durham, NC USA Duke Clin Res Inst Durham NC USADuke Clin Res Inst, Durham, NC USA Scripps Clin & Res Inst, La Jolla, CA USA Scripps Clin & Res Inst La Jolla CA USA lin & Res Inst, La Jolla, CA USA Cleveland Clin Fdn, Dept Biostat & Epidemiol, Cleveland, OH 44195 USA Cleveland Clin Fdn Cleveland OH USA 44195 demiol, Cleveland, OH 44195 USA Mother Francis Hosp, Tyler, TX USA Mother Francis Hosp Tyler TX USAMother Francis Hosp, Tyler, TX USA Mayo Clin & Mayo Fdn, Rochester, MN 55905 USA Mayo Clin & Mayo Fdn Rochester MN USA 55905 Fdn, Rochester, MN 55905 USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA Cardiovasc Res Fdn, Washington, DC USA Cardiovasc Res Fdn Washington DC USA diovasc Res Fdn, Washington, DC USA Montreal Heart Inst, Montreal, PQ H1T 1C8, Canada Montreal Heart Inst Montreal PQ Canada H1T 1C8 ntreal, PQ H1T 1C8, Canada
Titolo Testata:
CIRCULATION
fascicolo: 21, volume: 103, anno: 2001,
pagine: 2572 - 2578
SICI:
0009-7322(20010529)103:21<2572:PMPICW>2.0.ZU;2-H
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED TRIAL; UNSTABLE ANGINA; RECEPTOR; ABCIXIMAB; BLOCKADE; AGGREGATION; ANTIBODY; BINDING; IIIA; 7E3;
Keywords:
angioplasty; platelets; complications;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
21
Recensione:
Indirizzi per estratti:
Indirizzo: Steinhubl, SR Wilford Hall USAF Med Ctr, Dept Cardiol, 2200 Bergquist Dr, Lackland AFB, TX 78236 USA Wilford Hall USAF Med Ctr 2200 Bergquist Dr Lackland AFB TX USA 78236
Citazione:
S.R. Steinhubl et al., "Point-of-care measured platelet inhibition correlates with a reduced risk of an adverse cardiac event after percutaneous coronary intervention - Results of the GOLD (AU-Assessing Ultegra) multicenter study", CIRCULATION, 103(21), 2001, pp. 2572-2578

Abstract

Background-The optimal level of platelet inhibition with a glycoprotein (GP) IIb/IIIa antagonist necessary to minimize thrombotic complications in patients undergoing a percutaneous coronary intervention (PCI) is currently unknown. Methods and Results-Five hundred patients undergoing a PCI with the planned use of a GP IIb/IIIa inhibitor had platelet inhibition measured at 10 minutes, 1 hour, 8 hours, and 24 hours after the initiation of therapy with the Ultegra Rapid Platelet Function Assay (Accumetrics). Major adverse cardiac events (MACEs: composite of death, myocardial infarction, and urgent target vessel revascularization) were prospectively monitored, and the incidence correlated with the measured level of platelet function inhibition at alltime points. One quarter of all patients did not achieve greater than or equal to 95% inhibition 10 minutes after the bolus and experienced a significantly higher incidence of MACEs (14.4% versus 6.4%, P=0.006). Patients whose platelet function was <70% inhibited at 8 hours after the start of therapy had a MACE rate of 25% versus 8.1% for those <greater than or equal to>70% inhibited (P=0.009). By multivariate analysis, platelet function inhibition greater than or equal to 95% at 10 minutes after the start of therapy was associated with a significant decrease in the incidence of a MACE (odds ratio 0.46, 95% CI 0.22 to 0.96, P=0.04). Conclusions-Substantial variability in the level of platelet function inhibition is achieved with GP IIb/IIIa antagonist therapy among patients undergoing PCI. The level of platelet function inhibition as measured by a point-of-care assay is an independent predictor for the risk of MACEs after PCI.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/07/20 alle ore 21:29:29