Abciximab therapy improves survival in patients with acute myocardial infarction complicated by early cardiogenic shock undergoing coronary artery stent implantation

被引:45
作者
Antoniucci, D [1 ]
Valenti, R [1 ]
Migliorini, A [1 ]
Moschi, G [1 ]
Trapani, M [1 ]
Dovellini, EV [1 ]
Bolognese, L [1 ]
Santoro, GM [1 ]
机构
[1] Careggi Hosp, Div Cardiol, I-50314 Florence, Italy
关键词
D O I
10.1016/S0002-9149(02)02487-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The impact of abciximab therapy on mortality in patients with acute myocardial infarction (AMI) who are undergoing infarct-related artery (IRA) stent implantation, which is complicated by cardiogenic shock (CS) due to predominant ventricular failure has not been established, whereas concluded randomized trials comparing IRA stenting plus abciximab with IRA stenting alone in patients with AMI have produced conflicting results. Moreover, these trials have excluded patients with CS from randomization. This study sought to determine whether IRA stenting plus abciximab treatment has an impact on 1-month mortality compared with IRA stenting alone in consecutive patients with AMI complicated by CS due to predominant ventricular failure. Of 77 patients with CS and IRA stenting, 44 had abciximab therapy, whereas 33 underwent primary IRA stenting alone. There were no differences between groups in major baseline characteristics except for a higher incidence of women in the stent alone group compared with the abciximab group (36% vs 14%, p = 0.020). The 11-month overall mortality rate was 18% in the abciximab group and 42% in the stent alone group (p < 0.020). There were no differences between groups in reinfarction and target vessel revascularization rates. Multivariate analysis showed that abciximab therapy was the only variable that was independently related to 1-month mortality (odds ratio 0.36; 95% confidence intervals 0.15 to 0.86, p = 0.021). The results of this study support the use of abciximab in patients with AN complicated by CS who are undergoing IRA stent implantation. The mechanism of the clinical benefit of abciximab at I month was not related to the potency of the IRA. (C) 2002 by Excerpta Medica, Inc.
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页码:353 / 357
页数:5
相关论文
共 16 条
  • [1] Restenosis after coronary stenting in current clinical practice
    Antoniucci, D
    Valenti, R
    Santoro, GM
    Bolognese, L
    Trapani, M
    Cerisano, G
    Boddi, V
    Fazzini, PF
    [J]. AMERICAN HEART JOURNAL, 1998, 135 (03) : 510 - 518
  • [2] FAILURE OF SIMPLE CLINICAL MEASUREMENTS TO PREDICT PERFUSION STATUS AFTER INTRAVENOUS THROMBOLYSIS
    CALIFF, RM
    ONEIL, W
    STACK, RS
    ARONSON, L
    MARK, DB
    MANTELL, S
    GEORGE, BS
    CANDELA, RJ
    KEREIAKES, DJ
    ABBOTTSMITH, C
    TOPOL, EJ
    [J]. ANNALS OF INTERNAL MEDICINE, 1988, 108 (05) : 658 - 662
  • [3] ST-segment resolution and infarct-related artery patency and flow after thrombolytic therapy
    de Lemos, JA
    Antman, EM
    Giugliano, RP
    McCabe, CH
    Murphy, SA
    Van de Werf, F
    Gibson, CM
    Braunwald, E
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 2000, 85 (03) : 299 - 304
  • [4] Early revascularization in acute myocardial infarction complicated by cardiogenic shock
    Hochman, JS
    Sleeper, LA
    Webb, JG
    Sanborn, TA
    White, HD
    Talley, JD
    Buller, CE
    Jacobs, AK
    Slater, JN
    Col, J
    McKinlay, SM
    LeJemtel, TH
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1999, 341 (09) : 625 - 634
  • [5] *INJECT TRIAL GROU, 1995, J AM COLL CARDIOL, V26, P1657
  • [6] Prognostic significance of ST segment shift early after resolution of ST elevation in patients with myocardial infarction treated with thrombolytic therapy: The GUSTO-I ST segment monitoring substudy
    Langer, A
    Krucoff, MW
    Klootwijk, P
    Simoons, ML
    Granger, CB
    Barr, A
    Califf, RM
    Armstrong, PW
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1998, 31 (04) : 783 - 789
  • [7] Platelet glycoprotein IIb/IIIa inhibition with coronary stenting for acute myocardial infarction.
    Montalescot, G
    Barragan, P
    Wittenberg, O
    Ecollan, P
    Elhadad, S
    Villain, P
    Boulenc, JM
    Morice, MC
    Maillard, L
    Pansiéri, M
    Choussat, R
    Pinton, P
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2001, 344 (25) : 1895 - 1903
  • [8] Effect of glycoprotein IIb/IIIa receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction
    Neumann, FJ
    Kastrati, A
    Schmitt, C
    Blasini, R
    Hadamitzky, M
    Mehilli, J
    Gawaz, M
    Schleef, M
    Seyfarth, M
    Dirschinger, J
    Schömig, A
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (04) : 915 - 921
  • [9] Effect of glycoprotein IIb/IIIa receptor blockade on platelet-leukocyte interaction and surface expression of the leukocyte integrin Mac-1 in acute myocardial infarction
    Neumann, FJ
    Zohlnhöfer, D
    Fakhoury, L
    Ott, I
    Gawaz, M
    Schömig, A
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1999, 34 (05) : 1420 - 1426
  • [10] Effect of glycoprotein IIb/IIIa receptor blockade on recovery of coronary flow and left ventricular function after the placement of coronary-artery stents in acute myocardial infarction
    Neumann, FJ
    Blasini, R
    Schmitt, C
    Alt, E
    Dirschinger, J
    Gawaz, M
    Kastrati, A
    Schömig, A
    [J]. CIRCULATION, 1998, 98 (24) : 2695 - 2701