HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Eisenberg, M. J. Articles by Jamal, S. Search for Related Content PubMed PubMed Citation Articles by Eisenberg, M. J. Articles by Jamal, S.

VIEWPOINT

Glycoprotein IIb/IIIa inhibition in the setting of acute ST-segment elevation myocardial infarction

^* Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada

Manuscript received December 13, 2002; revised manuscript received March 26, 2003, accepted April 10, 2003.

^* Reprint requests and correspondence: Dr. Mark J. Eisenberg, Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital/McGill University, 3755 Cote Ste. Catherine Road/Suite A-118, Montreal, Quebec H3T 1E2, Canada.
marke{at}epid.jgh.mcgill.ca

Glycoprotein (GP) IIb/IIIa inhibitors have been extensively studied in the setting of percutaneous coronary intervention (PCI) and in the management of non–ST-segment elevation acute coronary syndromes. However, the use of GP IIb/IIIa inhibitors is less well established in the setting of acute ST-segment elevation myocardial infarction (MI). Multiple nonrandomized studies suggest that combination therapy with GP IIb/IIIa inhibitors and thrombolytic agents leads to increased rates of TIMI 3 flow. However, two clinical trials involving over 22,000 patients demonstrated that combination therapy is associated with only modest reductions in major adverse cardiac events, does not reduce mortality, and is associated with an increase in bleeding. In the setting of primary PCI, four clinical trials involving over 3,000 patients demonstrated that GP IIb/IIIa inhibition results in a significant decrease in the need for urgent target vessel revascularization but not in reductions of death or recurrent MI. Thus, GP IIb/IIIa inhibition may provide only limited benefits in the setting of acute ST-segment elevation MI.

Abbreviations and Acronyms   ADMIRAL = Abciximab Before Direct Angioplasty and Stenting in MI Regarding Acute and Long-term Follow-up   ASSENT-III = Assessment of the Safety and Efficacy of a New Thrombolytic-III   CADILLAC = Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications   GP = glycoprotein   GUSTO-V = Global Utilization of Strategies to open Occluded Coronary Arteries-V   IMPACT-AMI = Integrelin to Manage Platelet Aggregation to Combat Thrombosis in Acute Myocardial Infarction   INTRO AMI = Integrelin and Reduced-dose Thrombolytics in Acute Myocardial Infarction   ISAR-2 = Intracoronary Stenting and Antithrombotic Regimen-2   MI = myocardial infarction   PCI = percutaneous coronary intervention   RAPPORT = Reopro in Acute Myocardial Infarction and Primary PTCA Organization and Randomized Trial   SPEED = Strategies for Patency Enhancement in the Emergency Department   TIMI = Thrombolysis In Myocardial Infarction

This article has been cited by other articles:

				G. M. Howard-Alpe, J. de Bono, L. Hudsmith, W. P. Orr, P. Foex, and J. W. Sear Coronary artery stents and non-cardiac surgery Br. J. Anaesth., May 1, 2007; 98(5): 560 - 574. [Abstract] [Full Text] [PDF]

				T Heer, U Zeymer, C Juenger, A K Gitt, H Wienbergen, R Zahn, M Gottwik, J Senges, and for the Acute Coronary Syndromes (ACOS) Registry I Beneficial effects of abciximab in patients with primary percutaneous intervention for acute ST segment elevation myocardial infarction in clinical practice Heart, October 1, 2006; 92(10): 1484 - 1489. [Abstract] [Full Text] [PDF]

				Z. Huczek, J. Kochman, K. J. Filipiak, G. J. Horszczaruk, M. Grabowski, R. Piatkowski, J. Wilczynska, A. Zielinski, B. Meier, and G. Opolski Mean Platelet Volume on Admission Predicts Impaired Reperfusion and Long-Term Mortality in Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention J. Am. Coll. Cardiol., July 19, 2005; 46(2): 284 - 290. [Abstract] [Full Text] [PDF]

				H Suryapranata, G De Luca, A W J van 't Hof, J P Ottervanger, J C A Hoorntje, J-H E Dambrink, A T M Gosselink, F Zijlstra, and M-J de Boer Is routine stenting for acute myocardial infarction superior to balloon angioplasty? A randomised comparison in a large cohort of unselected patients Heart, May 1, 2005; 91(5): 641 - 645. [Abstract] [Full Text] [PDF]

				G. De Luca, H. Suryapranata, G. W. Stone, D. Antoniucci, J. E. Tcheng, F.-J. Neumann, F. Van de Werf, E. M. Antman, and E. J. Topol Abciximab as Adjunctive Therapy to Reperfusion in Acute ST-Segment Elevation Myocardial Infarction: A Meta-analysis of Randomized Trials JAMA, April 13, 2005; 293(14): 1759 - 1765. [Abstract] [Full Text] [PDF]

				B. J. Gersh, G. W. Stone, H. D. White, and D. R. Holmes Jr Pharmacological Facilitation of Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction: Is the Slope of the Curve the Shape of the Future? JAMA, February 23, 2005; 293(8): 979 - 986. [Abstract] [Full Text] [PDF]

				J. A. Barrabes, D. Garcia-Dorado, M. Mirabet, J. Inserte, L. Agullo, B. Soriano, A. Massaguer, F. Padilla, R.-M. Lidon, and J. Soler-Soler Antagonism of selectin function attenuates microvascular platelet deposition and platelet-mediated myocardial injury after transient ischemia J. Am. Coll. Cardiol., January 18, 2005; 45(2): 293 - 299. [Abstract] [Full Text] [PDF]

				D. Antoniucci, A. Migliorini, G. Parodi, R. Valenti, A. Rodriguez, A. Hempel, G. Memisha, and G. M. Santoro Abciximab-Supported Infarct Artery Stent Implantation for Acute Myocardial Infarction and Long-Term Survival: A Prospective, Multicenter, Randomized Trial Comparing Infarct Artery Stenting Plus Abciximab With Stenting Alone Circulation, April 13, 2004; 109(14): 1704 - 1706. [Abstract] [Full Text] [PDF]

				P. A. Lemos, F. Saia, S. H. Hofma, J. Daemen, A. T. L. Ong, C. A. Arampatzis, A. Hoye, E. McFadden, G. Sianos, P. C. Smits, et al. Short- and long-term clinical benefit of sirolimus-eluting stents compared to conventional bare stents for patients with acute myocardial infarction J. Am. Coll. Cardiol., February 18, 2004; 43(4): 704 - 708. [Abstract] [Full Text] [PDF]