Routine upfront abciximab versus standard periprocedural therapy in patients undergoing primary percutaneous coronary intervention for cardiogenic shock: The PRAGUE-7 Study. An open randomized multicentre study
Language English Country England, Great Britain Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
- MeSH
- Abciximab MeSH
- Survival Analysis MeSH
- Angioplasty, Balloon, Coronary methods MeSH
- Immunoglobulin Fab Fragments administration & dosage MeSH
- Myocardial Infarction complications drug therapy mortality pathology MeSH
- Platelet Aggregation Inhibitors administration & dosage MeSH
- Shock, Cardiogenic complications drug therapy mortality pathology MeSH
- Middle Aged MeSH
- Humans MeSH
- Antibodies, Monoclonal administration & dosage MeSH
- Prospective Studies MeSH
- Aged MeSH
- Stroke Volume MeSH
- Platelet Glycoprotein GPIIb-IIIa Complex antagonists & inhibitors MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Geographicals
- Czech Republic MeSH
- Names of Substances
- Abciximab MeSH
- Immunoglobulin Fab Fragments MeSH
- Platelet Aggregation Inhibitors MeSH
- Antibodies, Monoclonal MeSH
- Platelet Glycoprotein GPIIb-IIIa Complex MeSH
BACKGROUND: The outcome of acute myocardial infarction (AMI) complicated with cardiogenic shock is poor. The aim of this study was to analyse, whether upfront abciximab administration could improve the outcomes of cardiogenic shock. METHODS: This multicentre open trial randomized 80 patients with AMI complicated by cardiogenic shock expected to undergo primary PCI into group A (routine upfront-pre-procedural-abciximab bolus followed by 12-h abciximab infusion) and group B (standard therapy). The study primary objective was 30-day combined outcome (death/reinfarction/stroke/new severe renal failure). RESULTS: PCI was technically successful in 90% (A) versus 87.5% (B) patients. Abciximab was used in 100% (A) versus 35% (B). The primary endpoint occurred in 17 group A patients (42.5%) and 11 group B patients (27.5%, P = 0.24). Ejection fraction among survivors after 30 days was 44 ± 11% (A) versus 41 ± 12% (B, P = 0.205). Major bleeding occurred in 17.5% (A) versus 7.5% (B, P = 0.310). No differences (A versus B) were found in TIMI-flow and MBG after PCI. CONCLUSIONS: This study did not show any benefit from routine pre-procedural abciximab when compared with a selective abciximab use during the intervention in patients with cardiogenic shock undergoing primary PCI. However, small sample size of the trial preclude any definitive conclusion, a larger prospective, randomized, multicentered trial is needed.
References provided by Crossref.org
ClinicalTrials.gov
NCT00420030
