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Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI).

AbstractBACKGROUND:
This study investigated the efficacy and the safety of the upstream glycoprotein (Gp) IIb/IIIa inhibitor (clotinab; ISU ABXIS, Seoul, Republic of Korea) under 600-mg clopidogrel pretreatment compared with provisional use in ST-elevation myocardial infarction (STEMI).
METHODS AND RESULTS:
A total of 786 STEMI patients were randomized to upstream use in the emergency room (ER) (n = 392) or provisional use during percutaneous coronary intervention (PCI) (n = 394). All patients were prescribed 600-mg clopidogrel in the ER. The primary endpoint was the 30-day incidence of composite events including death, nonfatal myocardial infarction, target vessel revascularization, and stroke. There was no significant difference in the events that occurred in 40 patients (10.2%) in the upstream arm and 55 patients (14.0%) in the provisional arm during the 30 days (odds ratio 0.70, 95% confidence interval 0.45-1.08). Major bleeding was higher in the upstream arm (1.5% vs. 0%, P = 0.02). However, there was a significant reduction in 30-day composite events in the upstream arm in the high-risk population (Killip class ≥II or GRACE score >140).
CONCLUSIONS:
The upstream use of clotinab under a 600-mg clopidogrel loading may not significantly reduce cardiac events following primary PCI but may improve the clinical outcome in high-risk patients.
AuthorsJung-Sun Kim, Sang-Min Park, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, In Whan Seong, Byung Ok Kim, Hyeon-Cheol Gwon, Bum Kee Hong, Seung-Jae Tahk, Seong-Wook Park, Chong Jin Kim, Myung-Ho Jeong, Junghan Yoon, Yangsoo Jang, ECLAT-STEMI Trial investigators
JournalCirculation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 76 Issue 2 Pg. 405-13 ( 2012) ISSN: 1347-4820 [Electronic] Japan
PMID22146757 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Platelet Aggregation Inhibitors
  • Abciximab
Topics
  • Abciximab
  • Aged
  • Angioplasty, Balloon, Coronary (statistics & numerical data)
  • Antibodies, Monoclonal (administration & dosage)
  • Combined Modality Therapy
  • Coronary Angiography
  • Electrocardiography
  • Emergency Medical Services (methods, statistics & numerical data)
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin Fab Fragments (administration & dosage)
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction (diagnosis, drug therapy, mortality)
  • Platelet Aggregation Inhibitors (administration & dosage)
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome

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