Abciximab improves 6-month clinical outcome after rescue coronary angioplasty

“…Em fevereiro de 2002, o ensaio de um grupo de pesquisadores italianos com 89 pacientes divididos para uso de abciximab ou placebo durante a ATC de resgate demonstrou, em seguimento de trinta dias e seis meses, que o grupo que tomou abciximab obteve resultados superiores aos do grupo placebo em relação à recuperação da fração de ejeção, à taxa de eventos cardíacos maiores e ao risco de sangramento 26 .…”

Section: Uso Dos Inibidores Da Glicoproteína Iib/iiiaunclassified

Angioplastia de resgate no infarto agudo do miocárdio

Moraes¹,

Carvalho²

2007

Rev. Bras. Cardiol. Invasiva

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Background: Acute myocardial infarction is a serious and frequent illness, and its treatment with thrombolytic therapy or percutaneous coronary intervention (PCI) is well established. Rescue PCI is an alternative when thrombolysis fails. In the last ten years several clinical studies have tested different features about this procedure. Methods: Eighty four studies about rescue angioplasty published in the major cardiovascular relevance literary sources were analyzed between 1997 to 2007. Results: Rescue PCI was superior to conservative treatment, such as rethrombolysis, when well indicated, and seemed similar to primary PCI, in some features. The concomitant use of GPIIb/IIIa inhibitors seemed to show clinical benefits. The use of drug-eluting stents and the association with mechanic thrombectomy still requires better scientific support. The latest metaanalysis about this topic have shown clear favorable results to rescue angioplasty according to clinical outcomes, heart failure and re-infarction, but not so definite results as to mortality. On the other hand, there was a trend of increased stroke risk, of the same magnitude as benefit. Conclusion: Rescue PCI has better results than conservative treatment or repeat fibrinolysis. However, the indication of the procedure still needs more precise selection criteria as well as better definition of the clinical benefit/safety ratio. These uncertainties persist due to the small number of rescue angioplasty procedures compared to the total number of angioplasties performed. In the CENIC Registry, rescue angioplasty amounts to 4% of all angioplasties performed.

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“…Petronio et al, 18 . Studied the efficacy of Gp11b/ 111a inhibitor (abciximab) during rescue percutaneous coronary intervention in 79 patients.…”

Section: Materials and Methods: One Hundredmentioning

confidence: 99%

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2017

IJPSR

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ABSTRACT:We studied the feasibility, safety, clinical benefit, efficacy and 30 day outcome in 50 patients receiving tirofiban in patients with failed thrombolysis in acute ST elevation myocardial infarction, and compared with 50 patients for age, gender and infarct location, who did not receive rescue treatment for different reasons. Tirofiban resulted in an overall ST segment elevation, resolution, at 240 minutes in 44 patients (88 %). Incidence of major events during hospitalization was higher in control group. One patient (2 %) died in study group against 4(8%) in control group while 4 patients had refractory angina needing early percutaneous coronary intervention as compared to 13 in control group. None reinfarcted as against 4 in control group. Two patients developed congestive heart failure against 8 in control group. However, minor bleeding events (mainly gum) were significantly higher, 9 against 0 in control group. Coronary angiography revealed residual thrombus only in 4 patients treated with tirofiban compared to 13 in controls and surprisingly the number of stents required were less in study group (74 % i.e. 37 patients) against (96 % i.e. 48 patients) in control group. On 30 day follow up no death, congestive heart failure or repeat revascularization procedure was recorded in the study group with significant improvement in left ventricular ejection fraction, while as there were 3 deaths and 4 patients had congestive heart failure in control group INTRODUCTION: Success rate of intravenous thrombolysis is close to 70 %. Therefore stratigies for failed thrombolysis or reocclusion/ reinfarction also need to be planned in advance. Ongoing chest pain, non-resolution of ECG i.e. failure of the elevated ST segment to fall by 50% or more in lead with maximal ST elevation recorded 90 minutes after onset of thrombolysis, hemodynamic or electric instability indicate failure of recanalization. Repeat thrombolysis with the same or other agent is not to be practiced.

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Abciximab improves 6-month clinical outcome after rescue coronary angioplasty

Cited by 64 publications

References 28 publications

Efficacy and safety of glycoprotein IIb/IIIa receptor antagonists for patients undergoing percutaneous coronary intervention within twelve hours of fibrinolysis

Efficacy and safety of glycoprotein IIb/IIIa receptor antagonists for patients undergoing percutaneous coronary intervention within twelve hours of fibrinolysis

Angioplastia de resgate no infarto agudo do miocárdio

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