Skip to main content
Journal cover image

Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial.

Publication ,  Journal Article
Huber, K; Holmes, DR; van 't Hof, AW; Montalescot, G; Aylward, PE; Betriu, GA; Widimsky, P; Westerhout, CM; Granger, CB; Armstrong, PW
Published in: Eur Heart J
July 2010

AIMS: Controversy exists regarding the early use of glycoprotein IIb/IIIa inhibitors (GPIs) in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). The Assessment of Pexelizumab in Acute Myocardial Infarction (APEX-AMI) trial provides a unique opportunity to examine early vs. late or non-use of GPIs in a large STEMI cohort treated with PCI. METHODS AND RESULTS: In the APEX-AMI trial, 3969 of 5707 patients received one of three GPIs at the operator's discretion (abciximab, eptifibatide, tirofiban). Of GPI-treated patients, the median time from symptom onset to GPI administration was 180 min (25th, 75th percentile: 130, 258); 1125 received the agent prior to arriving in the catheterization laboratory [pre-sheath; GPI to sheath insertion: 37 min (16, 66)], whereas 2844 patients were treated after arrival in the catheterization laboratory [in-lab; sheath insertion to GPI: 16 min (10, 27)]. The pre-sheath use of GPIs was associated with a significantly lower hazard of 90-day mortality [adjusted hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.48-0.95, P = 0.025] and of 90-day composite of death/CHF/shock (adjusted HR 0.81, 95% CI 0.65-1.00, P = 0.054). In-hospital severe and moderate bleeding was not related to the use of GPIs. CONCLUSION: This retrospective analysis from a large patient cohort with acute STEMI undergoing PCI suggests that pharmacological pre-treatment of PCI with GPIs, particularly abciximab, was associated with significantly lower occurrence of 90-day clinical outcomes and supports the pre-procedural administration of GPIs in this clinical setting.

Duke Scholars

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 2010

Volume

31

Issue

14

Start / End Page

1708 / 1716

Location

England

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Retrospective Studies
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Immunoglobulin Fab Fragments
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Huber, K., Holmes, D. R., van ’t Hof, A. W., Montalescot, G., Aylward, P. E., Betriu, G. A., … Armstrong, P. W. (2010). Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial. Eur Heart J, 31(14), 1708–1716. https://doi.org/10.1093/eurheartj/ehq143
Huber, Kurt, David R. Holmes, Arnoud W. van ’t Hof, Gilles Montalescot, Philip E. Aylward, G Amadeo Betriu, Petr Widimsky, Cynthia M. Westerhout, Christopher B. Granger, and Paul W. Armstrong. “Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial.Eur Heart J 31, no. 14 (July 2010): 1708–16. https://doi.org/10.1093/eurheartj/ehq143.
Huber K, Holmes DR, van ’t Hof AW, Montalescot G, Aylward PE, Betriu GA, et al. Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial. Eur Heart J. 2010 Jul;31(14):1708–16.
Huber, Kurt, et al. “Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial.Eur Heart J, vol. 31, no. 14, July 2010, pp. 1708–16. Pubmed, doi:10.1093/eurheartj/ehq143.
Huber K, Holmes DR, van ’t Hof AW, Montalescot G, Aylward PE, Betriu GA, Widimsky P, Westerhout CM, Granger CB, Armstrong PW. Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial. Eur Heart J. 2010 Jul;31(14):1708–1716.
Journal cover image

Published In

Eur Heart J

DOI

EISSN

1522-9645

Publication Date

July 2010

Volume

31

Issue

14

Start / End Page

1708 / 1716

Location

England

Related Subject Headings

  • Tyrosine
  • Tirofiban
  • Retrospective Studies
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • Platelet Aggregation Inhibitors
  • Peptides
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Immunoglobulin Fab Fragments