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Recurrent ischemia during continuous 12-lead ECG-ischemia monitoring in patients with acute coronary syndromes treated with eptifibatide: relation with death and myocardial infarction. PURSUIT ECG-Ischemia Monitoring Substudy Investigators. Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy.

Publication ,  Journal Article
Akkerhuis, KM; Maas, AC; Klootwijk, PA; Krucoff, MW; Meij, S; Califf, RM; Simoons, ML
Published in: J Electrocardiol
April 2000

Computer-assisted continuous monitoring of the ST-segment allows detection and quantification of recurrent ischemia in patients with acute coronary syndromes. In a substudy of the PURSUIT (Platelet glycoprotein IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy) trial, this technique was used to evaluate the effects of the glycoprotein IIb/IIIa inhibitor eptifibatide on the incidence and severity of recurrent ischemia, and to investigate the relationship between recurrent ischemia and the occurrence of subsequent death or myocardial (re)infarction. A total of 258 patients with unstable angina or evolving myocardial infarction without ST elevation were monitored for 24 hours during infusion with either eptifibatide or placebo with a computer-assisted 12-lead ECG-ischemia monitoring device. Recurrent ischemic episodes were identified by an automated computer algorithm. Two hundred and sixteen patients (84%) had ECG recordings suitable for analysis. Ischemic episodes were detected in 35 (33%) of the 105 eptifibatide patients and in 32 (29%) of the 111 placebo patients (not significant). No difference in ischemic burden was apparent between both treatment groups. Patients who exhibited 2 or more episodes of recurrent ischemia more frequently died or suffered a myocardial infarction, both at 7 and 30 days, as well as through the 6-month follow-up. A greater ischemic burden was significantly related to adverse outcome during the 6-month follow-up period. Real-time computer-assisted continuous multilead ECG-ischemia monitoring may help to identify patients with unstable coronary syndromes at increased risk of adverse outcome and, thus, allow for better prognostic triage and more appropriate selection of therapeutic strategies. Integration of these systems in coronary care units and emergency wards should, therefore, be recommended.

Duke Scholars

Published In

J Electrocardiol

DOI

ISSN

0022-0736

Publication Date

April 2000

Volume

33

Issue

2

Start / End Page

127 / 136

Location

United States

Related Subject Headings

  • Signal Processing, Computer-Assisted
  • Recurrence
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Ischemia
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Models, Statistical
  • Middle Aged
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Journal cover image

Published In

J Electrocardiol

DOI

ISSN

0022-0736

Publication Date

April 2000

Volume

33

Issue

2

Start / End Page

127 / 136

Location

United States

Related Subject Headings

  • Signal Processing, Computer-Assisted
  • Recurrence
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Ischemia
  • Myocardial Infarction
  • Monitoring, Physiologic
  • Models, Statistical
  • Middle Aged