Abstract | BACKGROUND: 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.
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Authors | Jung-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 |
Journal | Circulation journal : official journal of the Japanese Circulation Society
(Circ J)
Vol. 76
Issue 2
Pg. 405-13
( 2012)
ISSN: 1347-4820 [Electronic] Japan |
PMID | 22146757
(Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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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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