Background When administered in conjunction with primary coronarystenting for the treatment of acute myocardial infarction, aplatelet glycoprotein IIb/IIIa inhibitor may provide additionalclinical benefit, but data on this combination therapy are limited.
Methods We randomly assigned 300 patients with acute myocardialinfarction in a double-blind fashion either to abciximab plusstenting (149 patients) or placebo plus stenting (151 patients)before they underwent coronary angiography. Clinical outcomeswere evaluated 30 days and 6 months after the procedure. Theangiographic patency of the infarct-related vessel and the leftventricular ejection fraction were evaluated at 24 hours and6 months.
Results At 30 days, the primary end point — a compositeof death, reinfarction, or urgent revascularization of the targetvessel — had occurred in 6.0 percent of the patients inthe abciximab group, as compared with 14.6 percent of thosein the placebo group (P=0.01); at 6 months, the correspondingfigures were 7.4 percent and 15.9 percent (P=0.02). The betterclinical outcomes in the abciximab group were related to thegreater frequency of grade 3 coronary flow (according to theclassification of the Thrombolysis in Myocardial Infarctiontrial) in this group than in the placebo group before the procedure(16.8 percent vs. 5.4 percent, P=0.01), immediately afterward(95.1 percent vs. 86.7 percent, P=0.04), and six months afterward(94.3 percent vs. 82.8 percent, P=0.04). One major bleedingevent occurred in the abciximab group (0.7 percent); none occurredin the placebo group.
Conclusions As compared with placebo, early administration ofabciximab in patients with acute myocardial infarction improvescoronary patency before stenting, the success rate of the stentingprocedure, the rate of coronary patency at six months, leftventricular function, and clinical outcomes.
Coronary stenting and antiplatelet therapy both play an importantpart in interventional cardiology,1,2,3 and the emergence anddevelopment of both therapies have been closely associated.4,5,6,7The combination of ticlopidine and aspirin enhances the benefitof coronary stenting by reducing acute stent thrombosis, andnew agents such as platelet glycoprotein IIb/IIIa inhibitors8limit ischemic complications in patients undergoing balloonangioplasty9,10,11,12 or stent implantation.13,14 However, despitethe potential link between fibrinogen and restenosis, blockadeof glycoprotein IIb/IIIa has not been shown to alter the frequencyof restenosis as determined by angiography or echocardiography.15,16
There are few data on the use of the combination of stentingand glycoprotein IIb/IIIa inhibition in patients with acutemyocardial infarction.17,18,19,20 A recent large, randomizedtrial of angioplasty with or without stent implantation showedthat stenting was beneficial in reducing the need for revascularizationbut found no reduction in the rates of death or reinfarction.20In contrast, glycoprotein IIb/IIIa inhibition decreased therate of ischemic events after balloon angioplasty but had noeffect on the need for revascularization at six months.21
This study (conducted by the Abciximab before Direct Angioplastyand Stenting in Myocardial Infarction Regarding Acute and Long-TermFollow-up [ADMIRAL] investigators) was a multicenter, double-blind,randomized trial with broad inclusion criteria, no angiographicselection criteria, and early randomization after presentation,to reflect the common practice of primary stenting in patientswith acute myocardial infarction. We hypothesized that abciximabfollowed by stenting would be superior to stenting alone.
Methods
Patients
Patients scheduled for primary percutaneous coronary revascularizationwere eligible for enrollment if they were more than 18 yearsold, had had the first symptoms of acute myocardial infarctionwithin 12 hours before enrollment, and had ST-segment elevationof more than 1 mm in at least two contiguous leads of the electrocardiogram.Exclusion criteria were bleeding diathesis, administration ofthrombolytic agents for the current episode, neoplasm, recentstroke, uncontrolled hypertension, recent surgery, oral anticoagulanttherapy, a limited life expectancy, childbearing potential,and known contraindications to therapy with aspirin, ticlopidine,or heparin. There were no angiographic selection criteria. Theethics review board of the Pitié–SalpêtrièreHospital approved the protocol, and the study was conductedin accordance with the Declaration of Helsinki. Written informedconsent was obtained from the patients.
Study Protocol
All the patients received aspirin and were randomly assigned,in the order in which they were enrolled, to receive eitherabciximab or placebo. The study drug was administered immediatelyafter randomization, in the mobile intensive care unit beforearrival at the hospital, in the emergency department, in theintensive cardiac care unit, or in the catheterization laboratory;in all cases it was administered before sheath insertion andcoronary angiography. The patients, investigators, and sponsorsof the study were blinded to the treatment assignments duringthe entire study. Patients received either abciximab (ReoPro,Centocor, Malvern, Pa.) as a bolus of 0.25 mg per kilogram ofbody weight, followed by a 12-hour infusion of 0.125 µgper kilogram per minute (maximum, 10 µg per minute), orplacebo.
Heparin was given as an initial bolus of 70 U per kilogram (maximum,7000 U). If necessary, additional boluses were administeredto achieve an activated clotting time of 200 seconds. Afterpercutaneous coronary revascularization, a continuous infusionof 7 U of heparin per kilogram per hour was initiated and maintaineduntil a coronary angiogram had been obtained, 24 hours afterthe procedure. The target activated partial-thromboplastin timewas between 1.5 and 2.0 times the control value. It was recommendedin the protocol that the investigators stop the administrationof heparin on completion of the 24-hour angiography study andthat they remove the sheaths 4 to 6 hours later. Ticlopidine(250 mg twice daily, without a loading dose) was given for the30 days immediately after stent implantation in both groups.Previously validated treatment algorithms for the managementof bleeding, emergency coronary-artery bypass surgery, and thrombocytopeniawere recommended in the protocol to decrease the likelihoodof hemorrhagic complications.12,13
Catheterization Procedures and Angiographic Analysis
A stent was implanted if the diameter of the infarct-relatedartery was greater than 2.5 mm, without extensive calcificationor unsuitable anatomical features. The first choice was theSaint-Côme stent (Saint-Côme-Chirurgie, Marseilles,France), a balloon-expandable, slotted tube stent, but the investigatorswere permitted to use an alternative stent if necessary.
All the patients who were randomly assigned to one of the twostudy groups were part of the angiographic analysis, which involvedfour coronary angiograms (obtained on admission, at the endof the percutaneous coronary revascularization procedure, and24 hours and 6 months after the procedure). Complete angiographicfollow-up at 6 months was carried out to evaluate the patencyof the target vessel unless the patient had died, had undergonerepeated revascularization, had had an occluded vessel at theend of the procedure or at 24 hours, had not undergone a revascularizationprocedure after the initial coronary angiography (e.g., becausethe rate of flow in the target vessel was classified as grade3 according to the classification of the Thrombolysis in MyocardialInfarction [TIMI] trial and the stenosis was judged to be lessthan 50 percent), or refused angiography at 6 months.
Cineangiograms were obtained according to standard acquisitionguidelines and submitted to an independent core angiographylaboratory, which was not one of the study centers. Analyseswere carried out on a per-lesion basis. Perfusion was gradedaccording to the TIMI classification system. Occlusion and reocclusionwere defined as a TIMI grade 0 or 1 flow in the occluded artery.Left ventricular volumes and ejection fractions were computedaccording to Simpson's rule from two orthogonal right anterioroblique and left anterior oblique views. Computerized quantitativeand qualitative analyses of angiograms were performed (Tagarno35AX Viewing Station, General Electric Medical Systems, Waukesha,Wis., and VIEW NT system with Quantitative Coronary Analysisand Ventricular Analysis software, Electromed InternationalSociety, Quebec, Que., Canada).22,23,24,25,26
End Points
The primary end point was the composite of death, reinfarction,or urgent revascularization of the target vessel at 30 daysafter randomization. The key secondary end point was the compositeof death, reinfarction, or any revascularization (percutaneouscoronary revascularization or coronary-artery bypass graftingon an urgent or elective basis) at 30 days and at 6 months.Other secondary end points were death or reinfarction at 30days and at 6 months; death, reinfarction, or urgent revascularizationof the target vessel at 6 months; the TIMI flow grade before,immediately after, 24 hours after, and 6 months after the revascularizationprocedure; and the left ventricular ejection fraction within24 hours and at 6 months after the revascularization procedure.
Reinfarction was defined according to clinical symptoms andnew electrocardiographic changes with a new elevation of thecreatine kinase or creatine kinase MB isoenzyme levels.12,21Creatine kinase and creatine kinase MB were measured beforethe administration of abciximab or placebo; 8, 16, 24, and 48hours afterward; and whenever reinfarction was suspected. Urgenttarget-vessel revascularization was defined as a repeated coronaryrevascularization procedure or coronary-artery bypass graftingperformed within 24 hours after a new ischemic episode. Episodesof bleeding were defined as major or minor according to theTIMI classification,27 and severe thrombocytopenia was definedby a platelet count of less than 50,000 per cubic millimeter.
Data were collected on case-report forms at the clinical studycenters and checked against medical records. A blinded clinical-eventsadjudication committee evaluated each event related to the primaryend point or the secondary end point. A clinical end-pointsand safety monitoring committee continuously checked and monitoredall adverse events in a blinded manner.
Statistical Analysis
When the study was planned, the incidence of the primary endpoint in the group of patients who were assigned to placebowas expected, according to the findings of observational studies,to be between 13 percent and 20 percent. The minimal samplesize was determined to be 150 patients per group to ensure 80percent power to detect a difference between a placebo groupin which the incidence of events was 15 percent and a treatmentgroup in which the incidence of events was 5 percent, with useof the chi-square test and at a two-sided significance levelof 5 percent. The data were retained by Eli Lilly, where theanalyses were performed. Independent statistical advice wasprovided by E. Vicant (Paris VII University). All analyses wereperformed on an intention-to-treat basis. The rates (percentages)reported for demographic, procedural, efficacy, and safety dataare based on observations in patients with no missing data.The percentages in the two groups were compared with use ofPearson's chi-square test or Fisher's exact test. Kaplan–Meiercurves were constructed for the primary end point at 30 daysand at 6 months. Continuous variables are presented as means±SD and were analyzed with a linear model that includedfixed effects of treatment, the investigator, and their interaction.Analyses among subgroups of the patients were planned in advance.
In a complementary analysis based on multiple logistic-regressionmodels, none of the base-line characteristics (including thediameter of the target coronary artery, the dose of heparin,and the type of stent) were found to have a significant effecton the incidence of the primary end point or the incidence ofdeath, and there was no significant interaction between thesevariables and the treatment effect. Consequently, unadjustedestimates of the relative risk were used in the current analyses.All the tests were two-sided, with significance levels of 5percent and two-sided 95 percent confidence intervals. All thecalculations were performed with SAS statistical software (version6.12, SAS Institute, Cary, N.C.).
Results
Base-Line Characteristics of the Patients
From July 12, 1997, to December 22, 1998, 300 patients withacute myocardial infarction were enrolled at 26 centers. Thetwo study groups were well matched with respect to base-linecharacteristics and key angiographic features (Table 1). Seventy-eightpatients (26 percent) were randomly assigned to one of the twostudy groups early (in the mobile intensive care unit or emergencydepartment), with either abciximab or placebo administered beforeand during transportation to the catheterization laboratory.The other 222 patients were randomly assigned to one of thestudy groups on admission to the intensive cardiac care unitor in the catheterization laboratory. The length of time betweenthe onset of chest pain and coronary angiography did not differamong these sites. The length of time between the onset of chestpain and administration of the bolus of the study drug was shorteramong the patients who received it in the mobile intensive careunit (178±94 minutes) than among those who received itin the emergency department (266±139 minutes, P=0.02)or in the intensive cardiac care unit or catheterization laboratory(238±142 minutes, P=0.002).
Table 1. Base-Line Characteristics of the Patients.
The prevalence of congestive heart failure was similar in thetwo groups, as was the incidence of cardiogenic shock duringthe first 24 hours after randomization. Initial angiographyshowed that the infarct-related vessel was small (referencediameter, <2.5 mm) in 12.5 percent of the patients; smallvessels were more frequently found in the abciximab group thanin the placebo group (18.3 percent vs. 5.9 percent, P=0.006).
After the initial angiogram, percutaneous coronary revascularizationwas attempted in 92 percent of the patients in the abciximabgroup and 95 percent of those in the placebo group; this smalldifference may reflect the more frequent presence of fully openarteries in those who received abciximab. Of the patients whounderwent balloon angioplasty, 92 percent received at leastone stent and 32 percent received more than one stent. The Saint-Cômestent was implanted in 66 percent of the patients who receiveda stent; the others received other stents (XT, Bard, MurrayHill, N.J.; Tenax, Biotronik, Bulak, Germany; NIR and NIR Primo,Boston Scientific, Natick, Mass.; Crossflex, Cordis, Miami;ACS Multi-Link and Duet Guidant, Indianapolis; Jostent, Jomed,Helsingborg, Sweden; and Bestent, GFX, and Wiktor, Medtronic,Minneapolis). Among the patients who received a stent, the incidenceof the primary end point was similar among those in whom a Saint-Cômestent was used and those in whom other stents were used (10.1percent vs. 9.9 percent, respectively; P=0.96). Ticlopidinewas given to 99 percent of the patients who received a stent.Doses of heparin and measurements of anticoagulation were similarin the study groups (activated clotting time, 316 seconds inthe abciximab group vs. 348 seconds in the placebo group; andactivated partial-thromboplastin time, 2.2 vs. 2.4 times thecontrol value, respectively, during revascularization).
Coronary Flow and Left Ventricular Function
The initial proportion of patients with TIMI grade 3 flow wassignificantly higher in the abciximab group than in the placebogroup (Table 2), and the difference between these two groupswas greater when TIMI grades 2 and 3 were considered together(rate in the abciximab group, 25.8 percent, vs. 10.8 percentin the placebo group; P=0.006). After the revascularizationprocedure, the proportion with TIMI grade 3 flow greatly increasedin both study groups and remained higher in the abciximab groupthan in the placebo group. The rate of procedural success (definedas stenosis of <50 percent and TIMI grade 3 flow) was higherwith abciximab than with placebo (95.1 percent vs. 84.3 percent,P=0.01). At six months, the frequency of both TIMI grade 3 flowand of TIMI grade 2 or 3 flow remained higher in the abciximabgroup than in the placebo group (rate of TIMI grade 2 or 3 flow,97.1 percent vs. 87.9 percent; P=0.04), with fewer angiographicallydetected reocclusions with abciximab than with placebo (2.9percent vs. 12.1 percent, P=0.04). At six months, abciximabwas also associated with a higher rate of patency in the subgroupof patients with small arteries (2.5 mm) than was placebo (TIMIgrade 2 or 3 flow, 100 percent vs. 60.0 percent; P=0.02). Abciximabwas associated with a more rapid and persistent improvementin left ventricular ejection fraction (improvement occurringwithin 24 hours and lasting at least 6 months) than placebo(Table 2).
Table 2. TIMI Flow Grades and Left Ventricular Ejection Fraction.
TIMI grade 3 flow at the end of the procedure was strongly relatedto the risk of both the 30-day and the 6-month clinical endpoints. The primary end point at 30 days had occurred in 7.4percent of the patients with TIMI grade 3 flow, as comparedwith 35.3 percent of the patients with TIMI grade 0, 1, or 2flow (P<0.001). This difference persisted at 6 months (P<0.001).Similarly, the incidence of the key secondary end point at 30days and 6 months was significantly lower in the patients withTIMI grade 3 flow than in those with a lower TIMI grade of flow.Moreover, the presence of TIMI grade 3 flow at the end of theprocedure was significantly related to the risk of death withinthe following 30 days or 6 months (6-month mortality, 2.3 percentamong patients with TIMI grade 3 flow, vs. 17.6 percent amongpatients with lower TIMI grades of flow; P=0.001), and abciximabhad a significant effect on this relation (P=0.03). The lowestmortality was seen among the patients who were assigned to abciximaband had TIMI grade 3 flow at the end of the revascularizationprocedure.
Clinical Outcomes
As compared with placebo, abciximab significantly reduced theincidence of the primary end point at 30 days, with a substantialreduction in each of the components of the end point (Table 3);the benefit was mainly observed during the first week afterstent implantation (Figure 1). When analyzed in subgroups accordingto clinical characteristics, most of the subgroups had similarbenefit with abciximab as compared with placebo (Figure 2).The incidence of the key secondary end point was also significantlylower in the abciximab group than in the placebo group at 30days. Episodes of minor bleeding occurred more frequently inthe abciximab group than in the placebo group, mainly in associationwith groin hematomas (Table 3).
Figure 1. Kaplan–Meier Curves Showing the Cumulative Incidence of the Primary End Point at 30 Days and at 6 Months.
The primary end point was the composite of death, reinfarction, and urgent target-vessel revascularization within 30 days after random assignment to treatment with abciximab or placebo. In the abciximab group, there was a 59 percent relative reduction in the risk of the primary end point at 30 days (P=0.01 for the comparison between the two groups) (top panel). At six months, there was a 53 percent reduction in the risk of the primary end point in the abciximab group (P=0.02 for the comparison between the two groups) (bottom panel).
Figure 2. Relative Risks of the Primary End Point at 30 Days and 6 Months, According to Subgroup.
The primary end point was death, reinfarction, or urgent target-vessel revascularization. Asterisks denote a significant difference between the two treatment groups (P<0.05). CI denotes confidence interval, MICU mobile intensive care unit, ER emergency room, ICCU intensive cardiac care unit, and CL catheterization laboratory.
The incidence of the primary end point at six months was significantlylower in the abciximab group than in the placebo group, withan absolute reduction of 8.5 percent (relative reduction, 53percent) and preservation of the early benefit (Figure 1). Anonsignificant, 55 percent reduction in mortality with abciximabas compared with placebo also persisted at six months. A consistentbenefit with abciximab was seen in all the subgroups of patients;the patients who received their randomly assigned treatmentwith abciximab early had a greater benefit with respect to theprimary end point at both 30 days and 6 months than did thosetreated with abciximab in the intensive cardiac care unit orcatheterization laboratory (Figure 2). At six months, the incidenceof the key secondary end point and the rates of target-vesselrevascularization were lower with abciximab than with placebo,suggesting that the drug had an effect on clinical restenosis(Table 3). Patients with diabetes who received abciximab hada significant reduction in the six-month mortality rate as comparedwith patients with diabetes who received placebo (0 percentvs. 16.7 percent, P=0.02), as well as a reduction in the incidenceof death, reinfarction, or any revascularization (20.7 percentvs. 50.0 percent, P=0.02), a reduction in the need for urgenttarget-vessel revascularization (0 percent vs. 12.5 percent,P=0.049), and a reduction in the need for any target-vesselrevascularization (13.8 percent vs. 37.5 percent, P=0.046).
Discussion
The complementary effects of platelet glycoprotein IIb/IIIainhibition and stenting have been previously shown in scheduled(i.e., elective) percutaneous coronary revascularization, butnot in primary revascularization for acute myocardial infarction.The results of this trial show that, as compared with placebo,abciximab therapy initiated before catheterization improvesoutcomes in patients with acute myocardial infarction who aretreated with primary stenting. Abciximab in combination withstent placement reduces both the incidence of acute ischemicevents and the incidence of end points related to clinical restenosis.This study also shows that in comparison with stenting alone,the addition of abciximab (along with aspirin) as a first-linetreatment for acute myocardial infarction more frequently opensthe occluded artery, improves the success of stenting, reducesthe rate of reocclusion, and more frequently restores an optimalflow for up to six months, with concomitant improvements inboth left ventricular ejection fraction and prognosis.
To reflect as closely as possible the real practice of primarypercutaneous coronary revascularization, patients were selectedfor the study only on the basis of typical chest pain with ST-segmentelevation on the electrocardiogram; there were few clinicalexclusion criteria and no angiographic criteria for the selectionof patients. In this high-risk population, the benefits seenwith abciximab are consistent with those in a recent open-labeltrial of stenting that included patients with Q-wave or non–Q-wavemyocardial infarction within 48 hours after the onset of pain.17
The benefit of abciximab, as compared with placebo, was observedeven in specific subgroups of patients with acute myocardialinfarction who are usually excluded from trials of stenting— namely, those with small arteries or with cardiogenicshock. In patients with diabetes, abciximab reduced the six-monthrates of death and clinical restenosis, confirming previousresults in patients undergoing elective stenting.28 Althoughthey constituted a prespecified subgroup, the patients withdiabetes were few in number, and there was no specific stratificationfor diabetes. Therefore, caution is required in the interpretationof these results; whether abciximab has specific effects indiabetic patients remains to be fully explored. In addition,the number of women in the trial was small, and there was inadequatepower to allow us to draw meaningful conclusions about thistherapeutic approach in women.
As with thrombolytic agents,29 the administration of abciximabearly after presentation resulted in a higher initial frequencyof TIMI grade 3 flow than that achieved with placebo. As comparedwith placebo, it led to a better rate of procedural successwith stenting, which translated into a better 24-hour left ventricularejection fraction (a change that may have involved other mechanisms,such as less distal emboli, less side-branch closure,13 or improvementsin microcirculation).17 Treatment during the first few hoursafter acute myocardial infarction is critical to the long-termprognosis,30,31,32,33 and early TIMI grade 3 flow is importantin reducing the risk of death, as shown in the Global Utilizationof Streptokinase and Tissue Plasminogen Activator for OccludedCoronary Arteries (GUSTO) trial.29 The relation found in thecurrent study between the presence of TIMI grade 3 flow andrisk of death at both 30 days and 6 months is consistent withthe idea that platelet glycoprotein IIb/IIIa inhibition helpsboth to achieve coronary-artery patency and to improve the prognosis(and thus supports the "open-artery" hypothesis).
Although low doses of heparin were recommended,12,13 the investigatorsmay have given higher doses in the context of the double-blindstudy design. The activated clotting time or activated partial-thromboplastintime measured during the procedure in the placebo group wasin agreement with a consensus statement34 and recent studiesof stenting.20,35 However, in the abciximab group, these dosesof heparin resulted in excessively high activated clotting times,leading to an increase in the incidence of groin hematomas (whichmay also be related to the use of a sheath that is left in placefor 24 hours). To limit the risk of hematomas with powerfulantiplatelet agents, leaving the sheath in for prolonged periodsmust be strongly discouraged, whereas low doses of heparin andcareful management of the femoral access site are advisable.12Oral antiplatelet therapy in the current study was based onthe ticlopidine regimen that has been tested and approved forstent implantation.5,6,7 Although most intervention centershave recently switched from ticlopidine to clopidogrel withor without a loading dose, recent data showed no differencebetween these two drugs in the prevention of major cardiac events,36and the results presented here probably apply equally to patientsreceiving clopidogrel.
In acute myocardial infarction, the administration of both aspirinand a glycoprotein platelet IIb/IIIa inhibitor at presentationfacilitates acute reperfusion. In addition, we found that arapid and aggressive antiplatelet strategy, in generally unselectedpatients with acute myocardial infarction who were treated withprimary stenting, led to improved outcomes. This strategy isfeasible, effective, and safe. The results thus add supportto the "open-artery" hypothesis with IIb/IIIa inhibition inprimary coronary stenting.
Supported by Eli Lilly, Saint-Cloud, France, and Indianapolis,and by Saint-Côme-Chirurgie, Marseilles, France.
Dr. Pinton is an employee of and stockholder in Eli Lilly. Dr.Montalescot has served as a consultant to Eli Lilly.
We are indebted to Eric Topol, M.D. (Cleveland Clinic Foundation,Cleveland), for expert editorial assistance; to Eric Vicaut,M.D., Ph.D. (Fernand Widal Hospital, Paris), for statisticalassistance; to Valérie Moreau, Isabelle Bouvard, andNathalie Berkani (Eli Lilly, Saint-Cloud, France) for assistancein coordinating the study and for data management and analysis;and to Marcel Mazéas for enthusiastic support in initiatingthe study.
* The members of the ADMIRAL (Abciximab before Direct Angioplastyand Stenting in Myocardial Infarction Regarding Acute and Long-TermFollow-up) study group are listed in the Appendix.
Source Information
From the Division of Cardiology (G.M., R.C.), the Department of Anesthesiology, and the Mobile Intensive Care Unit (P.E.), Pitié–Salpêtrière Hospital, Paris; the Divisions of Cardiology, Beauregard Clinic, Marseilles (P.B.), Des Franciscaines Clinic, Nîmes (O.W.), Lagny–Marne-la-Vallée Hospital, Lagny-sur-Marne (S.E.), Les Fleurs Clinic, Ollioules (P.V.), Saint-Joseph Clinic, Colmar (J.-M.B.), Institut Cardiovasculaire Paris Sud, Antony (M.-C.M.), Trousseau Hospital, Tours (L.M.), and Henri Duffaut Hospital, Avignon (M.P.); and the Cardiovascular Therapeutic Unit, Eli Lilly, Saint-Cloud (P.P.) — all in France.
Address reprint requests to Dr. Montalescot at the Service de Cardiologie, Centre Hospitalier Universitaire Pitié–Salpêtrière, 47 Blvd. de l'Hôpital, 75013, Paris, France, or at gilles.montalescot{at}psl.ap-hop-paris.fr.
References
Serruys PW, de Jaegere P, Kiemeneij F, et al. A comparison of balloon-expandable-stent implantation with balloon angioplasty in patients with coronary artery disease. N Engl J Med 1994;331:489-495. [Free Full Text]
Fischman DL, Leon MB, Baim DS, et al. A randomized comparison of coronary-stent placement and balloon angioplasty in the treatment of coronary artery disease. N Engl J Med 1994;331:496-501. [Free Full Text]
Serruys PW, van Hout B, Bonnier H, et al. Randomised comparison of implantation of heparin-coated stents with balloon angioplasty in selected patients with coronary artery disease (Benestent II). Lancet 1998;352:673-681. [Erratum, Lancet 1998;352:1478.] [CrossRef][ISI][Medline]
Barragan P, Sainsous J, Silvestri M, et al. Ticlopidine and subcutaneous heparin as an alternative regimen following coronary stenting. Cathet Cardiovasc Diagn 1994;32:133-138. [ISI][Medline]
Schömig A, Neumann F-J, Kastrati A, et al. A randomized comparison of antiplatelet and anticoagulant therapy after the placement of coronary-artery stents. N Engl J Med 1996;334:1084-1089. [Free Full Text]
Bertrand ME, Legrand V, Boland J, et al. Randomized multicenter comparison of conventional anticoagulation versus antiplatelet therapy in unplanned and elective coronary stenting: the Full Anticoagulation versus Aspirin and Ticlopidine (FANTASTIC) study. Circulation 1998;98:1597-1603. [Free Full Text]
Cutlip DE, Leon MB, Ho KK, et al. Acute and nine-month clinical outcomes after "suboptimal" coronary stenting: results from the STent Anti-thrombotic Regimen Study (STARS) Registry. J Am Coll Cardiol 1999;34:698-706. [Free Full Text]
Coller BS. GPIIb/IIIa antagonists: pathophysiologic and therapeutic insights from studies of c7E3 Fab. Thromb Haemost 1997;78:730-735. [ISI][Medline]
The EPIC Investigators. Use of a monoclonal antibody directed against the platelet glycoprotein IIb/IIIa receptor in high-risk coronary angiography. N Engl J Med 1994;330:956-961. [Free Full Text]
Topol EJ, Califf RM, Weisman HF, et al. Randomised trial of coronary intervention with antibody against platelet IIb/IIIa integrin for reduction of clinical restenosis: results at six months. Lancet 1994;343:881-886. [CrossRef][ISI][Medline]
Randomised placebo-controlled trial of abciximab before and during coronary intervention in refractory unstable angina: the CAPTURE Study. Lancet 1997;349:1429-1435. [Erratum, Lancet 1997;350:744.] [CrossRef][ISI][Medline]
The EPILOG Investigators. Platelet glycoprotein IIb/IIIa receptor blockade and low-dose heparin during percutaneous coronary revascularization. N Engl J Med 1997;336:1689-1696. [Free Full Text]
Lincoff AM, Califf RM, Moliterno DJ, et al. Complementary clinical benefits of coronary-artery stenting and blockade of platelet glycoprotein IIb/IIIa receptors. N Engl J Med 1999;341:319-327. [Free Full Text]
Novel dosing regimen of eptifibatide in planned coronary stent implantation (ESPRIT): a randomised, placebo-controlled trial. Lancet 2000;356:2037-2044. [CrossRef][ISI][Medline]
Montalescot G, Ankri A, Vicaut E, Drobinski G, Grosgogeat Y, Thomas D. Fibrinogen after coronary angioplasty as a risk factor for restenosis. Circulation 1995;92:31-38. [Free Full Text]
The ERASER Investigators. Acute platelet inhibition with abciximab does not reduce in-stent restenosis (ERASER study). Circulation 1999;100:799-806. [Free Full Text]
Neumann FJ, Blasini R, Schmitt C, et al. Effect of glycoprotein IIb/IIIa receptor blockade on recovery of coronary flow and left ventricular function after the placement of coronary-artery stents in acute myocardial infarction. Circulation 1998;98:2695-2701. [Free Full Text]
Stone GW. Stenting in acute myocardial infarction: observational studies and randomized trials. J Invasive Cardiol 1998;10:Suppl A:16A-26A.
Suryapranata H, van't Hof AWJ, Hoorntje JCA, de Boer MJ, Zijlstra F. Randomized comparison of coronary stenting with balloon angioplasty in selected patients with acute myocardial infarction. Circulation 1998;97:2502-2505. [Free Full Text]
Grines CL, Cox DA, Stone GW, et al. Coronary angioplasty with or without stent implantation for acute myocardial infarction. N Engl J Med 1999;341:1949-1956. [Free Full Text]
Brener SJ, Barr LA, Burchenal JEB, et al. Randomized, placebo-controlled trial of platelet glycoprotein IIb/IIIa blockade with primary angioplasty for acute myocardial infarction. Circulation 1998;98:734-741. [Free Full Text]
Sander H. Left ventricular volume, mass and related measures: usefulness in determination of ventricular function. In: Snellen HA, ed. Quantitation in cardiology. Leiden, the Netherlands: Leiden University Press, 1972:189-99.
Reiber JHC, Kooijman CJ, Slager CJ, et al. Coronary artery dimensions from cineangiograms: methodology and validation of a computer assisted procedure. IEEE Trans Med Imaging 1984;3:131-141.
Lefree MT, Simon SB, Mancini GBJ, Vogel RA. Digital radiographic assessment of coronary arterial diameter and videodensitometric cross-sectional area. Proc SPIE 1986;626:334-41.
Azancot I, Krone RJ, Eiferman C, et al. Permanent electronic storage of angiographic images in the catheterization laboratory: high-resolution and real-time acquisition on optical laserdiscs. J Invasive Cardiol 1997;9:96-108. [Medline]
Rao AK, Pratt C, Berke A, et al. Thrombolysis in Myocardial Infarction (TIMI) Trial -- phase I: hemorrhagic manifestations and changes in plasma fibrinogen and the fibrinolytic system in patients treated with recombinant tissue plasminogen activator and streptokinase. J Am Coll Cardiol 1988;11:1-11. [Abstract]
Marso SP, Lincoff AM, Ellis SG, et al. Optimizing the percutaneous interventional outcomes for patients with diabetes mellitus: results of the EPISTENT (Evaluation of Platelet IIb/IIIa Inhibition for Stenting Trial) diabetic substudy. Circulation 1999;100:2477-2484. [Free Full Text]
The GUSTO Angiographic Investigators. The effects of tissue plasminogen activator, streptokinase, or both on coronary-artery patency, ventricular function, and survival after acute myocardial infarction. N Engl J Med 1993;329:1615-1622. [Erratum, N Engl J Med 1994;330:516.] [Free Full Text]
Newby LK, Rutsch WR, Califf RM, et al. Time from symptom onset to treatment and outcomes after thrombolytic therapy. J Am Coll Cardiol 1996;27:1646-1655. [Abstract]
Leizorovicz A, Haugh MC, Mercier C, Boissel JP. Pre-hospital and hospital time delays in thrombolytic treatment in patients with suspected acute myocardial infarction: analysis of data from the EMIP study. Eur Heart J 1997;18:248-253. [Free Full Text]
Berger PB, Ellis SG, Holmes DR Jr, et al. Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction: results from the Global Use of Strategies to Open Occluded Arteries in Acute Coronary Syndromes (GUSTO-IIb) trial. Circulation 1999;100:14-20. [Free Full Text]
Morrison LJ, Verbeek PR, McDonald AC, Sawadsky BV, Cook DJ. Mortality and prehospital thrombolysis for acute myocardial infarction: a meta-analysis. JAMA 2000;283:2686-2692. [Free Full Text]
Dalen JE, Hirsh J, eds. American College of Chest Physicians Conference on Antithrombotic Therapy. Chest 1998;114:439S-769S. [ISI][Medline]
Neumann FJ, Kastrati A, Schmitt C, et al. Effects of glycoprotein IIb/IIIa receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction. J Am Coll Cardiol 2000;35:915-921. [Free Full Text]
Bertrand ME, Rupprecht HJ, Gershlick AH, et al. Double-blind study of the safety of clopidogrel with and without a loading dose in combination with aspirin compared with ticlopidine in combination with aspirin after coronary stenting: the CLopidogrel Aspirin Stent International Cooperative Study (CLASSICS). Circulation 2000;102:624-629. [Free Full Text]
Appendix
The following persons participated in the trial: Trial Organization:Steering Committee: G. Montalescot (chairperson) (Groupe HospitalierPitié–Salpêtrière, Paris), P. Barragan(Clinique Beauregard, Marseilles), and P. Pinton (Eli Lilly,Saint-Cloud); Clinical End Points and Safety Monitoring Committee:A. Leizorovicz (chairperson) (Hôpital Louis Pradel, Lyons),A. Cribier (Hôpital Charles Nicolle, Rouen), and M. MeyerSamama (Hôpital Hôtel Dieu, Paris); Clinical EventsAdjudication Committee: J.L. Dubois Randé (chairperson)(Hôpital Henri Mondor, Créteil), M. Slama (HôpitalAntoine Béclère, Clamart), and K. Boughalem (HôpitalBroussais, Paris); Angiographic Core Laboratory: I. Azancot(chairperson) and V. Stratiev (Hôpital Lariboisière,Paris); Trial Investigators:Pitié–SalpêtrièreHospital, Paris: G. Montalescot, Cardiology Division (42 patientsenrolled), and P. Ecollan, mobile intensive care unit (26);Des Franciscaines Clinic, Nîmes: O. Wittenberg, CardiologyDivision (44), and J.E. De La Coussaye, University Hospitaland mobile intensive care unit (4); Lagny-Marne-la-ValléeHospital, Lagny-sur-Marne: S. Elhadad (28); Les Fleurs Clinic,Ollioules: P. Villain (24); Saint-Joseph Clinic, Colmar: J.M.Boulenc (20); Institut Cardiovasculaire Paris Sud, Antony: M.-C.Morice (18); Trousseau Hospital, Tours: L. Maillard (12); HenriDuffaut Hospital, Avignon: M. Pansieri, Cardiology Division(8), and J. Vaque, mobile intensive care unit (3); Les AlpillesClinic,Marseilles: P. Barragan (10); La Valette Clinic, Montpellier:X. De Boisgelin (10); Centre Hospitalier Intercommunal, Eaubonne-Montmorency,Montmorency: A. Akesbi (8); Pays d'Aix Hospital, Aix-en-Provence:C. Barnay (7); Essey-Les-Nancy Clinic, Essey-Les-Nancy: M. Amor(6) and P.E. Bollaert, Hôpital Central, Nancy, and mobileintensive care unit (1); René Dubos Hospital, Pontoise:F. Funck (5); Boucicaut Hospital, Paris: A. Lafont (4); CentreMedico Chirurgical Obstetrical, Schiltigheim: M. Zupan (4);Hôpital Nord, Marseilles: F. Paganelli (4); Saint-JosephHospital, Marseilles: F. Dhoudain (3); Necker Hospital, Paris:J.P. Metzger (3); Rhône-Durance Clinic,Avignon: J. Sainsous(3); Haut Lévesque Hospital, Pessac: P. Coste (2); andLa Cavale Blanche Hospital, Brest: J.P. Boschat (1) —all in France.
Martin-Rendon, E., Brunskill, S. J., Hyde, C. J., Stanworth, S. J., Mathur, A., Watt, S. M.
(2008). Autologous bone marrow stem cells to treat acute myocardial infarction: a systematic review. Eur Heart J
29: 1807-1818
[Abstract][Full Text]
Thiele, H., Schindler, K., Friedenberger, J., Eitel, I., Furnau, G., Grebe, E., Erbs, S., Linke, A., Mobius-Winkler, S., Kivelitz, D., Schuler, G.
(2008). Intracoronary Compared With Intravenous Bolus Abciximab Application in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: The Randomized Leipzig Immediate Percutaneous Coronary Intervention Abciximab IV Versus IC in ST-Elevation Myocardial Infarction Trial. Circulation
118: 49-57
[Abstract][Full Text]
Jaffe, R., Charron, T., Puley, G., Dick, A., Strauss, B. H.
(2008). Microvascular Obstruction and the No-Reflow Phenomenon After Percutaneous Coronary Intervention. Circulation
117: 3152-3156
[Full Text]
Patel, S. S., Rana, H., Mascarenhas, D. A. N.
(2008). Intracoronary Abciximab Use in Patients Undergoing PCI at a Community Hospital: A Single Operator Experience. J CARDIOVASC PHARMACOL THER
13: 89-93
[Abstract]
Goodman, S. G., Menon, V., Cannon, C. P., Steg, G., Ohman, E. M., Harrington, R. A.
(2008). Acute ST-Segment Elevation Myocardial Infarction: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest
133: 708S-775S
[Abstract][Full Text]
Stone, G. W., Witzenbichler, B., Guagliumi, G., Peruga, J. Z., Brodie, B. R., Dudek, D., Kornowski, R., Hartmann, F., Gersh, B. J., Pocock, S. J., Dangas, G., Wong, S. C., Kirtane, A. J., Parise, H., Mehran, R., the HORIZONS-AMI Trial Investigators,
(2008). Bivalirudin during Primary PCI in Acute Myocardial Infarction. NEJM
358: 2218-2230
[Abstract][Full Text]
Waldmann, A., Katalinic, A., Schwaab, B., Richardt, G., Sheikhzadeh, A., Raspe, H.
(2008). The TeleGuard trial of additional telemedicine care in CAD patients. 2 Morbidity and mortality after 12 months. J Telemed Telecare
14: 22-26
[Abstract][Full Text]
Moliterno, D. J., Ziada, K. M.
(2008). The safety and efficacy of glycoprotein IIb/IIIa inhibitors for primary angioplasty: more options to choose and more time to decide.. J Am Coll Cardiol
51: 536-537
[Full Text]
Grayburn, P. A., Choi, J. W.
(2008). Advances in the assessment of no-reflow after successful primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: now that we can diagnose it, what do we do about it?. J Am Coll Cardiol
51: 566-568
[Full Text]
Reynolds, H. R., Hochman, J. S.
(2008). Cardiogenic Shock: Current Concepts and Improving Outcomes. Circulation
117: 686-697
[Full Text]
Wilson, J. M., Willerson, J. T.
(2008). Myocardial Revascularization with Percutaneous Devices. Card Surg Adult
3: 573-598
[Full Text]
George, I., Oz, M. C.
(2008). Myocardial Revascularization after Acute Myocardial Infarction. Card Surg Adult
3: 669-696
[Full Text]
Brasselet, C., Tassan, S., Nazeyrollas, P., Hamon, M., Metz, D.
(2007). Randomised comparison of femoral versus radial approach for percutaneous coronary intervention using abciximab in acute myocardial infarction: results of the FARMI Trial. Heart
93: 1556-1561
[Abstract][Full Text]
Dobrzycki, S., Kralisz, P., Nowak, K., Prokopczuk, P., Kochman, W., Korecki, J., Poniatowski, B., Zuk, J., Sitniewska, E., Bachorzewska-Gajewska, H., Sienkiewicz, J., Musial, W. J
(2007). Transfer with GP IIb/IIIa inhibitor tirofiban for primary percutaneous coronary intervention vs. on-site thrombolysis in patients with ST-elevation myocardial infarction (STEMI): a randomized open-label study for patients admitted to community hospitals. Eur Heart J
28: 2438-2448
[Abstract][Full Text]
Boden, W. E., Eagle, K., Granger, C. B.
(2007). Reperfusion Strategies in Acute ST-Segment Elevation Myocardial Infarction: A Comprehensive Review of Contemporary Management Options. J Am Coll Cardiol
50: 917-929
[Abstract][Full Text]
Chassot, P.-G., Delabays, A., Spahn, D. R.
(2007). Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction. Br J Anaesth
99: 316-328
[Abstract][Full Text]
Kiernan, T. J., Ting, H. H., Gersh, B. J.
(2007). Facilitated percutaneous coronary intervention: current concepts, promises, and pitfalls. Eur Heart J
28: 1545-1553
[Abstract][Full Text]
Menichelli, M., Parma, A., Pucci, E., Fiorilli, R., De Felice, F., Nazzaro, M., Giulivi, A., Alborino, D., Azzellino, A., Violini, R.
(2007). Randomized Trial of Sirolimus-Eluting Stent Versus Bare-Metal Stent in Acute Myocardial Infarction (SESAMI). J Am Coll Cardiol
49: 1924-1930
[Abstract][Full Text]
Meadows, T. A., Bhatt, D. L.
(2007). Clinical Aspects of Platelet Inhibitors and Thrombus Formation. Circ. Res.
100: 1261-1275
[Abstract][Full Text]
Piek, J. J.
(2007). Beyond Epicardial Reperfusion. NEJM
356: 1880-1882
[Full Text]
Maioli, M., Bellandi, F., Leoncini, M., Toso, A., Dabizzi, R. P.
(2007). Randomized Early Versus Late Abciximab in Acute Myocardial Infarction Treated With Primary Coronary Intervention (RELAx-AMI Trial). J Am Coll Cardiol
49: 1517-1524
[Abstract][Full Text]
Jacobson, K. M, Hall Long, K., McMurtry, E. K, Naessens, J. M, Rihal, C. S
(2007). The economic burden of complications during percutaneous coronary intervention. Qual Saf Health Care
16: 154-159
[Abstract][Full Text]
Montalescot, G., Antoniucci, D., Kastrati, A., Neumann, F. J., Borentain, M., Migliorini, A., Boutron, C., Collet, J.-P., Vicaut, E.
(2007). Abciximab in primary coronary stenting of ST-elevation myocardial infarction: a European meta-analysis on individual patients' data with long-term follow-up. Eur Heart J
28: 443-449
[Abstract][Full Text]
Dzau, V. J., Antman, E. M., Black, H. R., Hayes, D. L., Manson, J. E., Plutzky, J., Popma, J. J., Stevenson, W.
(2006). The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part II: Clinical Trial Evidence (Acute Coronary Syndromes Through Renal Disease) and Future Directions. Circulation
114: 2871-2891
[Full Text]
Montalescot, G.
(2006). Glycoprotein IIb/IIIa Inhibitors in the Elderly: Fear of Age or Age of Fear?. Circulation
114: 2004-2006
[Full Text]
Ndrepepa, G., Kastrati, A., Mehilli, J., Neumann, F.-J., ten Berg, J., Bruskina, O., Dotzer, F., Seyfarth, M., Pache, J., Dirschinger, J., Ulm, K., Berger, P. B., Schomig, A.
(2006). Age-Dependent Effect of Abciximab in Patients With Acute Coronary Syndromes Treated With Percutaneous Coronary Interventions. Circulation
114: 2040-2046
[Abstract][Full Text]
Collet, J.-P., Montalescot, G., Le May, M., Borentain, M., Gershlick, A.
(2006). Percutaneous Coronary Intervention After Fibrinolysis: A Multiple Meta-Analyses Approach According to the Type of Strategy. J Am Coll Cardiol
48: 1326-1335
[Abstract][Full Text]
Heer, T, Zeymer, U, Juenger, C, Gitt, A K, Wienbergen, H, Zahn, R, Gottwik, M, Senges, J, for the Acute Coronary Syndromes (ACOS) Registry I,
(2006). Beneficial effects of abciximab in patients with primary percutaneous intervention for acute ST segment elevation myocardial infarction in clinical practice. Heart
92: 1484-1489
[Abstract][Full Text]
Schachinger, V., Erbs, S., Elsasser, A., Haberbosch, W., Hambrecht, R., Holschermann, H., Yu, J., Corti, R., Mathey, D. G., Hamm, C. W., Suselbeck, T., Assmus, B., Tonn, T., Dimmeler, S., Zeiher, A. M., the REPAIR-AMI Investigators,
(2006). Intracoronary bone marrow-derived progenitor cells in acute myocardial infarction.. NEJM
355: 1210-1221
[Abstract][Full Text]
Assmus, B., Honold, J., Schachinger, V., Britten, M. B., Fischer-Rasokat, U., Lehmann, R., Teupe, C., Pistorius, K., Martin, H., Abolmaali, N. D., Tonn, T., Dimmeler, S., Zeiher, A. M.
(2006). Transcoronary transplantation of progenitor cells after myocardial infarction.. NEJM
355: 1222-1232
[Abstract][Full Text]
Borden, W. B., Faxon, D. P.
(2006). Facilitated Percutaneous Coronary Intervention. J Am Coll Cardiol
48: 1120-1128
[Abstract][Full Text]
Ali, A., Cox, D., Dib, N., Brodie, B., Berman, D., Gupta, N., Browne, K., Iwaoka, R., Azrin, M., Stapleton, D., Setum, C., Popma, J., for the AIMI Investigators,
(2006). Rheolytic Thrombectomy With Percutaneous Coronary Intervention for Infarct Size Reduction in Acute Myocardial Infarction: 30-Day Results From a Multicenter Randomized Study. J Am Coll Cardiol
48: 244-252
[Abstract][Full Text]
Mangano, D. T., Miao, Y., Tudor, I. C., Dietzel, C., for the Investigators of the Multicenter Study of, , and the Ischemia Research and Education Foundation,
(2006). Post-Reperfusion Myocardial Infarction: Long-Term Survival Improvement Using Adenosine Regulation With Acadesine. J Am Coll Cardiol
48: 206-214
[Abstract][Full Text]
Dominguez, J., Kanna, B.
(2006). Three-year duration of benefit from abciximab in patient receiving stents for acute myocardial infarction in the randomized double-blind ADMIRAL study. Eur Heart J
27: 1508-1509
[Full Text]
Montalescot, G.
(2006). Three-year duration of benefit from abciximab in patient receiving stents for acute myocardial infarction in the randomized double-blind ADMIRAL study: reply. Eur Heart J
27: 1509-1509
[Full Text]
Sharma, S., Makkar, R., Lardizabal, J.
(2006). Intracoronary Administration of Abciximab During Percutaneous Coronary Interventions: Should This Be the Routine and Preferred Approach?. J CARDIOVASC PHARMACOL THER
11: 136-141
[Abstract]
Smith, S. C. Jr, Feldman, T. E., Hirshfeld, J. W. Jr, Jacobs, A. K., Kern, M. J., King, S. B. III, Morrison, D. A., O'Neill, W. W., Schaff, H. V., Whitlow, P. L., Williams, D. O., Antman, E. M., Smith, S. C. Jr, Adams, C. D., Anderson, J. L., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B.
(2006). ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). J Am Coll Cardiol
47: 216-235
[Full Text]
Smith, S. C. Jr, Feldman, T. E., Hirshfeld, J. W. Jr, Jacobs, A. K., Kern, M. J., King, S. B. III, Morrison, D. A., O'Neill, W. W., Schaff, H. V., Whitlow, P. L., Williams, D. O., Antman, E. M., Smith, S. C. Jr, Adams, C. D., Anderson, J. L., Faxon, D. P., Fuster, V., Halperin, J. L., Hiratzka, L. F., Hunt, S. A., Jacobs, A. K., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B.
(2006). ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention--Summary Article: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention). Circulation
113: 156-175
[Full Text]
Svilaas, T., van der Horst, I. C.C., Zijlstra, F.
(2005). The role of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention for ST elevation myocardial infarction. Eur Heart J
26: 2479-2481
[Full Text]
The ADMIRAL Investigators,
(2005). Three-year duration of benefit from abciximab in patients receiving stents for acute myocardial infarction in the randomized double-blind ADMIRAL study. Eur Heart J
26: 2520-2523
[Abstract][Full Text]
Smith, E J, Mathur, A, Rothman, M T
(2005). Recent advances in primary percutaneous intervention for acute myocardial infarction. Heart
91: 1533-1536
[Full Text]
de Belder, A
(2005). Should primary angioplasty be available for all patients with an ST elevation myocardial infarction?. Heart
91: 1509-1511
[Abstract][Full Text]
Dawkins, K D, Gershlick, T, de Belder, M, Chauhan, A, Venn, G, Schofield, P, Smith, D, Watkins, J, Gray, H H, Joint Working Group on Percutaneous Coronary Inter,
(2005). Percutaneous coronary intervention: recommendations for good practice and training. Heart
91: vi1-vi27
[Abstract][Full Text]
Ince, H., Petzsch, M., Kleine, H. D., Schmidt, H., Rehders, T., Korber, T., Schumichen, C., Freund, M., Nienaber, C. A.
(2005). Preservation From Left Ventricular Remodeling by Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Use of Granulocyte-Colony-Stimulating Factor (FIRSTLINE-AMI). Circulation
112: 3097-3106
[Abstract][Full Text]
Kanna, B., Almadi, R.
(2005). Mechanical Reperfusion More Than 12 Hours After Acute Myocardial Infarction. JAMA
294: 2031-2031
[Full Text]
Szummer, K. E., Solomon, S. D., Velazquez, E. J., Kilaru, R., McMurray, J., Rouleau, J.-L., Mahaffey, K. W., Maggioni, A. P., Califf, R. M., Pfeffer, M. A., White, H. D., on behalf of the VALIANT registry,
(2005). Heart failure on admission and the risk of stroke following acute myocardial infarction: the VALIANT registry. Eur Heart J
26: 2114-2119
[Abstract][Full Text]
Zeymer, U., Zahn, R., Schiele, R., Jansen, W., Girth, E., Gitt, A., Seidl, K., Schroder, R., Schneider, S., Senges, J.
(2005). Early eptifibatide improves TIMI 3 patency before primary percutaneous coronary intervention for acute ST elevation myocardial infarction: results of the randomized integrilin in acute myocardial infarction (INTAMI) pilot trial. Eur Heart J
26: 1971-1977
[Abstract][Full Text]
Huber, K., Caterina, R. D., Kristensen, S. D., Verheugt, F. W.A., Montalescot, G., Maestro, L. B., Werf, F. V. d., for the Task Force on Pre-hospital Reperfusion The,
(2005). Pre-hospital reperfusion therapy: a strategy to improve therapeutic outcome in patients with ST-elevation myocardial infarction. Eur Heart J
26: 2063-2074
[Full Text]
Ferenc, M., Neumann, F.-J.
(2005). Efficacy of primary PCI: the microvessel perspective. Eur Heart J Suppl
7: I4-I9
[Abstract][Full Text]
Beygui, F., Montalescot, G.
(2005). The use of GP IIb/IIIa inhibitors into new perspectives: pre-catheterization laboratory administration. Eur Heart J Suppl
7: I10-I14
[Abstract][Full Text]
Dudek, D., Mielecki, W., Dziewierz, A., Legutko, J., Dubiel, J. S.
(2005). The role of thrombectomy and embolic protection devices. Eur Heart J Suppl
7: I15-I20
[Abstract][Full Text]
Migliorini, A., Antoniucci, D.
(2005). Patient selection bias in primary percutaneous coronary intervention trials: a critical issue. Eur Heart J Suppl
7: I21-I26
[Abstract][Full Text]
Valgimigli, M., Percoco, G., Cicchitelli, G., Campo, G., Gardini, E., Pellegrino, L., Malagutti, P., Giretti, C., Ferrari, R.
(2005). New and old strategies to afford the liberal use of drug-eluting stents in real-life scenarios. Eur Heart J Suppl
7: K31-K35
[Abstract][Full Text]
Bonnefoy, E., Steg, P. G., Chabaud, S., Dubien, P.-Y., Lapostolle, F., Boudet, F., Lacroute, J.-M., Dissait, F., Vanzetto, G., Leizorowicz, A., Touboul, P., for the CAPTIM investigators,
(2005). Is primary angioplasty more effective than prehospital fibrinolysis in diabetics with acute myocardial infarction? Data from the CAPTIM randomized clinical trial. Eur Heart J
26: 1712-1718
[Abstract][Full Text]
De Luca, G., Suryapranata, H., Grimaldi, R., Chiariello, M.
(2005). Coronary stenting and abciximab in primary angioplasty for ST-segment-elevation myocardial infarction. QJM
98: 633-641
[Abstract][Full Text]
Ince, H., Petzsch, M., Kleine, H. D., Eckard, H., Rehders, T., Burska, D., Kische, S., Freund, M., Nienaber, C. A.
(2005). Prevention of Left Ventricular Remodeling With Granulocyte Colony-Stimulating Factor After Acute Myocardial Infarction: Final 1-year Results of the Front-Integrated Revascularization and Stem Cell Liberation in Evolving Acute Myocardial Infarction by Granulocyte Colony-Stimulating Factor (FIRSTLINE-AMI) Trial. Circulation
112: I-73-I-80
[Abstract][Full Text]
Mitsias, P. D., Lu, M., Silver, B., Morris, D., Ewing, J. R., Daley, S., Lewandowski, C., Katramados, A., Papamitsakis, N. I., Ebadian, H. B., Zhao, Q., Soltanian-Zadeh, H., Hearshen, D., Patel, S. C., Chopp, M.
(2005). MRI-guided, open trial of abciximab for ischemic stroke within a 3- to 24-hour window. Neurology
65: 612-615
[Abstract][Full Text]
Le May, M. R., Wells, G. A., Labinaz, M., Davies, R. F., Turek, M., Leddy, D., Maloney, J., McKibbin, T., Quinn, B., Beanlands, R. S., Glover, C., Marquis, J.-F., O'Brien, E. R., Williams, W. L., Higginson, L. A.
(2005). Combined Angioplasty and Pharmacological Intervention Versus Thrombolysis Alone in Acute Myocardial Infarction (CAPITAL AMI Study). J Am Coll Cardiol
46: 417-424
[Abstract][Full Text]
Krombach, G. A., Higgins, C. B., Chujo, M., Saeed, M.
(2005). Gadomer-enhanced MR Imaging in the Detection of Microvascular Obstruction: Alleviation with Nicorandil Therapy. Radiology
236: 510-518
[Abstract][Full Text]
Fassa, A-A, Urban, P, Radovanovic, D, Duvoisin, N, Gaspoz, J-M, Stauffer, J-C, Erne, P, for the AMIS Plus Investigators,
(2005). Trends in reperfusion therapy of ST segment elevation myocardial infarction in Switzerland: six year results from a nationwide registry. Heart
91: 882-888
[Abstract][Full Text]
Schomig, A., Mehilli, J., Antoniucci, D., Ndrepepa, G., Markwardt, C., Di Pede, F., Nekolla, S. G., Schlotterbeck, K., Schuhlen, H., Pache, J., Seyfarth, M., Martinoff, S., Benzer, W., Schmitt, C., Dirschinger, J., Schwaiger, M., Kastrati, A., for the Beyond 12 hours Reperfusion AlternatiVe Ev,
(2005). Mechanical Reperfusion in Patients With Acute Myocardial Infarction Presenting More Than 12 Hours From Symptom Onset: A Randomized Controlled Trial. JAMA
293: 2865-2872
[Abstract][Full Text]
Sakuma, T., Sari, I., Goodman, C. N., Lindner, J. R., Klibanov, A. L., Kaul, S.
(2005). Simultaneous integrin {alpha}v{beta}3 and glycoprotein IIb/IIIa inhibition causes reduction in infarct size in a model of acute coronary thrombosis and primary angioplasty. Cardiovasc Res
66: 552-561
[Abstract][Full Text]
Andersen, H R, Terkelsen, C J, Thuesen, L, Krusell, L R, Kristensen, S D, Botker, H E, Lassen, J F, Nielsen, T T
(2005). Myocardial infarction centres: the way forward. Heart
91: iii12-iii15
[Abstract][Full Text]
Valgimigli, M., Percoco, G., Malagutti, P., Campo, G., Ferrari, F., Barbieri, D., Cicchitelli, G., McFadden, E. P., Merlini, F., Ansani, L., Guardigli, G., Bettini, A., Parrinello, G., Boersma, E., Ferrari, R., for the STRATEGY Investigators,
(2005). Tirofiban and Sirolimus-Eluting Stent vs Abciximab and Bare-Metal Stent for Acute Myocardial Infarction: A Randomized Trial. JAMA
293: 2109-2117
[Abstract][Full Text]
Sciagra, R., Parodi, G., Pupi, A., Migliorini, A., Valenti, R., Moschi, G., Santoro, G. M., Memisha, G., Antoniucci, D.
(2005). Gated SPECT Evaluation of Outcome After Abciximab-Supported Primary Infarct Artery Stenting for Acute Myocardial Infarction: The Scintigraphic Data of the Abciximab and Carbostent Evaluation (ACE) Randomized Trial. JNM
46: 722-727
[Abstract][Full Text]
De Luca, G., Suryapranata, H., Stone, G. W., Antoniucci, D., Tcheng, J. E., Neumann, F.-J., Van de Werf, F., Antman, E. M., Topol, E. J.
(2005). Abciximab as Adjunctive Therapy to Reperfusion in Acute ST-Segment Elevation Myocardial Infarction: A Meta-analysis of Randomized Trials. JAMA
293: 1759-1765
[Abstract][Full Text]
Lansky, A. J., Pietras, C., Costa, R. A., Tsuchiya, Y., Brodie, B. R., Cox, D. A., Aymong, E. D., Stuckey, T. D., Garcia, E., Tcheng, J. E., Mehran, R., Negoita, M., Fahy, M., Cristea, E., Turco, M., Leon, M. B., Grines, C. L., Stone, G. W.
(2005). Gender Differences in Outcomes After Primary Angioplasty Versus Primary Stenting With and Without Abciximab for Acute Myocardial Infarction: Results of the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Trial. Circulation
111: 1611-1618
[Abstract][Full Text]
Terkelsen, C. J., Lassen, J. F., Norgaard, B. L., Gerdes, J. C., Poulsen, S. H., Bendix, K., Ankersen, J. P., Gotzsche, L. B.-H., Romer, F. K., Nielsen, T. T., Andersen, H. R.
(2005). Reduction of treatment delay in patients with ST-elevation myocardial infarction: impact of pre-hospital diagnosis and direct referral to primary percutanous coronary intervention. Eur Heart J
26: 770-777
[Abstract][Full Text]
Authors/Task Force Members, , Silber, S., Albertsson, P., Aviles, F. F., Camici, P. G., Colombo, A., Hamm, C., Jorgensen, E., Marco, J., Nordrehaug, J.-E., Ruzyllo, W., Urban, P., Stone, G. W., Wijns, W.
(2005). Guidelines for Percutaneous Coronary Interventions: The Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology. Eur Heart J
26: 804-847
[Full Text]
De Luca, G., van 't Hof, A. W.J., Ottervanger, J. P., Hoorntje, J. C.A., Gosselink, A.T. M., Dambrink, J.-H. E., de Boer, M.-J., Suryapranata, H.
(2005). Ageing, impaired myocardial perfusion, and mortality in patients with ST-segment elevation myocardial infarction treated by primary angioplasty. Eur Heart J
26: 662-666
[Abstract][Full Text]
Iglesias-Garriz, I., Fernandez-Vazquez, F., Perez, A., Jimenez-Bonilla, J., Garrote, C., Uriarte, P., DelaFuente, C.
(2005). Preinfarction Angina Limits Myocardial Infarction Size in Nondiabetic Patients Treated With Primary Coronary Angioplasty. Chest
127: 1116-1121
[Abstract][Full Text]
Flaherty, J. D., Davidson, C. J.
(2005). Diabetes and Coronary Revascularization. JAMA
293: 1501-1508
[Abstract][Full Text]
Bouki, K. P., Pavlakis, G., Papasteriadis, E.
(2005). Management of Cardiogenic Shock Due to Acute Coronary Syndromes. ANGIOLOGY
56: 123-130
[Abstract]
Brophy, J. M., Joseph, L.
(2005). Medical Decision Making with Incomplete Evidence--Choosing a Platelet Glycoprotein IIbIIIa Receptor Inhibitor for Percutaneous Coronary Interventions. Med Decis Making
25: 222-228
[Abstract]
Yip, H.-K., Hang, C.-L., Fang, C.-Y., Hsieh, Y.-K., Yang, C.-H., Hung, W.-C., Wu, C.-J.
(2005). Level of High-Sensitivity C-Reactive Protein Is Predictive of 30-Day Outcomes in Patients With Acute Myocardial Infarction Undergoing Primary Coronary Intervention. Chest
127: 803-808
[Abstract][Full Text]
Lansky, A. J., Hochman, J. S., Ward, P. A., Mintz, G. S., Fabunmi, R., Berger, P. B., New, G., Grines, C. L., Pietras, C. G., Kern, M. J., Ferrell, M., Leon, M. B., Mehran, R., White, C., Mieres, J. H., Moses, J. W., Stone, G. W., Jacobs, A. K., Endorsed by the American College of Cardiology Fou,
(2005). Percutaneous Coronary Intervention and Adjunctive Pharmacotherapy in Women: A Statement for Healthcare Professionals From the American Heart Association. Circulation
111: 940-953
[Abstract][Full Text]
Mehta, R. H., Granger, C. B., Alexander, K. P., Bossone, E., White, H. D., Sketch, M. H. Jr
(2005). Reperfusion strategies for acute myocardial infarction in the elderly: Benefits and risks. J Am Coll Cardiol
45: 471-478
[Abstract][Full Text]
Wollert, K. C., Drexler, H.
(2005). Clinical Applications of Stem Cells for the Heart. Circ. Res.
96: 151-163
[Abstract][Full Text]
Tang, W.H. W., Lincoff, A. M.
(2004). Diabetes, Coronary Intervention, and Platelet Glycoprotein IIb/IIIa Blockade: The Triad Revisited. Circulation
110: 3618-3620
[Full Text]
Gyongyosi, M., Domanovits, H., Benzer, W., Haugk, M., Heinisch, B., Sodeck, G., Hodl, R., Gaul, G., Bonner, G., Wojta, J., Laggner, A., Glogar, D., Huber, K., for the ReoPro-BRIDGING Study Group,
(2004). Use of abciximab prior to primary angioplasty in STEMI results in early recanalization of the infarct-related artery and improved myocardial tissue reperfusion - results of the Austrian multi-centre randomized ReoPro-BRIDGING Study. Eur Heart J
25: 2125-2133
[Abstract][Full Text]
Schachinger, V., Assmus, B., Britten, M. B., Honold, J., Lehmann, R., Teupe, C., Abolmaali, N. D., Vogl, T. J., Hofmann, W.-K., Martin, H., Dimmeler, S., Zeiher, A. M.
(2004). Transplantation of progenitor cells and regeneration enhancement in acute myocardial infarction: Final one-year results of the TOPCARE-AMI Trial. J Am Coll Cardiol
44: 1690-1699
[Abstract][Full Text]
Collet, J.P., Montalescot, G., Blanchet, B., Tanguy, M.L., Golmard, J.L., Choussat, R., Beygui, F., Payot, L., Vignolles, N., Metzger, J.P., Thomas, D.
(2004). Impact of Prior Use or Recent Withdrawal of Oral Antiplatelet Agents on Acute Coronary Syndromes. Circulation
110: 2361-2367
[Abstract][Full Text]
Guagliumi, G., Stone, G. W., Cox, D. A., Stuckey, T., Tcheng, J. E., Turco, M., Musumeci, G., Griffin, J. J., Lansky, A. J., Mehran, R., Grines, C. L., Garcia, E.
(2004). Outcome in Elderly Patients Undergoing Primary Coronary Intervention for Acute Myocardial Infarction: Results From the Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications (CADILLAC) Trial. Circulation
110: 1598-1604
[Abstract][Full Text]
Ndrepepa, G., Kastrati, A., Neumann, F.-J., Schmitt, C., Mehilli, J., Schomig, A.
(2004). Five-year outcome of patients with acute myocardial infarction enrolled in a randomised trial assessing the value of abciximab during coronary artery stenting. Eur Heart J
25: 1635-1640
[Abstract][Full Text]
Hanefeld, C., Sirtl, C., Spiecker, M., Bojara, W., Grewe, P. H., Lawo, T., Mugge, A.
(2004). Prehospital Therapy With the Platelet Glycoprotein IIb/IIIa Inhibitor Eptifibatide in Patients With Suspected Acute Coronary Syndromes: The Bochum Feasibility Study. Chest
126: 935-941
[Abstract][Full Text]
Popma, J. J., Berger, P., Ohman, E. M., Harrington, R. A., Grines, C., Weitz, J. I.
(2004). Antithrombotic Therapy During Percutaneous Coronary Intervention: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest
126: 576S-599S
[Abstract][Full Text]
2.5 mm) than was placebo (TIMI grade 2 or 3 flow, 100 percent vs. 60.0 percent; P=0.02). Abciximab was associated with a more rapid and persistent improvement in left ventricular ejection fraction (improvement occurring within 24 hours and lasting at least 6 months) than placebo (Table 2). 
Previous
