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Timing of glycoprotein IIb/IIIa inhibitor use and outcomes among patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (results from CRUSADE).

Publication ,  Journal Article
Tricoci, P; Peterson, ED; Chen, AY; Newby, LK; Harrington, RA; Greenbaum, AB; Cannon, CP; Gibson, CM; Hoekstra, JW; Pollack, CV; Ohman, EM ...
Published in: Am J Cardiol
May 15, 2007

Although glycoprotein (GP) IIb/IIIa inhibitors are recommended for patients with unstable angina and non-ST-segment elevation myocardial infarction who undergo percutaneous coronary intervention (PCI), the American College of Cardiology/American Heart Association guidelines do not specify optimal timing for their initiation. We compared patient characteristics and clinical outcomes in 30,830 patients with non-ST-segment elevation myocardial infarction included in the CRUSADE initiative (January 2001 to December 2004) who underwent PCI with upstream (>1 hour before PCI) or periprocedural use of GP IIb/IIIa inhibitors. GP IIb/IIIa inhibitors were administered upstream in 43% of patients versus periprocedurally in 57%. Time from arrival to PCI was longer for patients who received GP IIb/IIIa inhibitors upstream (median 25.6 hours) compared with periprocedurally (18.2 hours). Unadjusted incidence of in-hospital death or reinfarction was lower with upstream GP IIb/IIIa inhibitor use (3.8% vs 4.3%, p = 0.046), but after adjusting for patient and hospital characteristics, this difference was not statistically significant. Treatment with upstream GP IIb/IIIa inhibitors was associated with a lower incidence of unadjusted death or reinfarction in patients who underwent PCI <12 hours from hospital arrival. In conclusion, in this observational analysis, overall ischemic outcomes were similar between the 2 groups, but clinical trials are needed to solve the controversy over optional timing of GP IIb/IIIa inhibitor use.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

May 15, 2007

Volume

99

Issue

10

Start / End Page

1389 / 1393

Location

United States

Related Subject Headings

  • United States
  • Tyrosine
  • Treatment Outcome
  • Tirofiban
  • Time Factors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged
 

Citation

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Tricoci, P., Peterson, E. D., Chen, A. Y., Newby, L. K., Harrington, R. A., Greenbaum, A. B., … Roe, M. T. (2007). Timing of glycoprotein IIb/IIIa inhibitor use and outcomes among patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (results from CRUSADE). Am J Cardiol, 99(10), 1389–1393. https://doi.org/10.1016/j.amjcard.2006.12.066
Tricoci, Pierluigi, Eric D. Peterson, Anita Y. Chen, L Kristin Newby, Robert A. Harrington, Adam B. Greenbaum, Chistopher P. Cannon, et al. “Timing of glycoprotein IIb/IIIa inhibitor use and outcomes among patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (results from CRUSADE).Am J Cardiol 99, no. 10 (May 15, 2007): 1389–93. https://doi.org/10.1016/j.amjcard.2006.12.066.
Tricoci, Pierluigi, et al. “Timing of glycoprotein IIb/IIIa inhibitor use and outcomes among patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (results from CRUSADE).Am J Cardiol, vol. 99, no. 10, May 2007, pp. 1389–93. Pubmed, doi:10.1016/j.amjcard.2006.12.066.
Tricoci P, Peterson ED, Chen AY, Newby LK, Harrington RA, Greenbaum AB, Cannon CP, Gibson CM, Hoekstra JW, Pollack CV, Ohman EM, Gibler WB, Roe MT. Timing of glycoprotein IIb/IIIa inhibitor use and outcomes among patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (results from CRUSADE). Am J Cardiol. 2007 May 15;99(10):1389–1393.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

May 15, 2007

Volume

99

Issue

10

Start / End Page

1389 / 1393

Location

United States

Related Subject Headings

  • United States
  • Tyrosine
  • Treatment Outcome
  • Tirofiban
  • Time Factors
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged