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Titolo:
Effect of glycoprotein IIb/IIIa receptor inhibition on angiographic complications during percutaneous coronary intervention in the ESPRIT trial
Autore:
Blankenship, JC; Tasissa, G; OShea, JC; Iliadis, EA; Bachour, FA; Cohen, DJ; Lui, HK; Mann, T; Cohen, E; Tcheng, JE;
Indirizzi:
Geisinger Med Ctr, Dept Cardiol, Danville, PA 17822 USA Geisinger Med CtrDanville PA USA 17822 t Cardiol, Danville, PA 17822 USA Duke Univ, Duke Clin Res Inst, Durham, NC USA Duke Univ Durham NC USADuke Univ, Duke Clin Res Inst, Durham, NC USA Beth Israel Hosp, Boston, MA USA Beth Israel Hosp Boston MA USABeth Israel Hosp, Boston, MA USA Jackson Madison Gen, Jackson, TN USA Jackson Madison Gen Jackson TN USAJackson Madison Gen, Jackson, TN USA Wake Heart Associates, Raleigh, NC USA Wake Heart Associates Raleigh NC USA e Heart Associates, Raleigh, NC USA Sunnybrook Med Ctr, Toronto, ON, Canada Sunnybrook Med Ctr Toronto ON Canada ybrook Med Ctr, Toronto, ON, Canada
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 38, anno: 2001,
pagine: 653 - 658
SICI:
0735-1097(200109)38:3<653:EOGIRI>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELEVATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
13
Recensione:
Indirizzi per estratti:
Indirizzo: Blankenship, JC Geisinger Med Ctr, Dept Cardiol, 21-60, Danville, PA 17822USA Geisinger Med Ctr 21-60 Danville PA USA 17822 PA 17822 USA
Citazione:
J.C. Blankenship et al., "Effect of glycoprotein IIb/IIIa receptor inhibition on angiographic complications during percutaneous coronary intervention in the ESPRIT trial", J AM COL C, 38(3), 2001, pp. 653-658

Abstract

OBJECTIVES We sought to determine whether eptifibatide decreases the incidence of in-laboratory angiographic complications and to determine the relationship of angiographically evident complications to elevations of creatinekinase-MB (CK-MB) enzyme levels during percutaneous coronary intervention. BACKGROUND In the Enhanced Suppression of the Platelet IIb/IIIa Receptor with Integrilin Therapy (ESPRIT) trial, eptifibatide during coronary intervention was associated with decreased ischemic complications at 48 h and 30 days. METHODS Patients (n = 2,064) were randomized to placebo versus eptifibatide (two 180 mug/kg boluses 10 min apart and as a continuous infusion of 2;mug/kg per min) during percutaneous coronary stenting. Angiographic complications including major dissection, distal embolization, residual thrombus, abrupt closure, residual stenosis > 50% and side-branch occlusion were prospectively recorded by the operator. Creatine kinase-MB levels were measured after the procedure and every 6 h thereafter. The incidence of angiographic complications and CK-MB elevation was determined for eptifibatide versus placebo groups. RESULTS Eptifibatide-treated patients demonstrated nonsignificant trends toward fewer angiographic complications (10 vs. 12% for placebo patients, p = 0.13) and, for patients with angiographic complications, fewer subsequentCK-MB elevations (43 vs. 50% for placebo patients, p = 0.31). In patients without any angiographic complications, the incidence of CK-MB elevation >3times the normal was 7% with placebo and 4% with eptifibatide (p = 0.003). CONCLUSIONS Eptifibatide during nonurgent coronary stent intervention onlyminimally (and insignificantly) reduces the incidence of angiographic complications and subsequent CK-MB elevations in patients developing an angiographic complication. The greater effect is to reduce myocardial infarction in patients undergoing otherwise uneventful coronary stent implantation as well as in the overall study population. (C) 2001 by the American College ofCardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/07/20 alle ore 12:58:00