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Abciximab, Small Molecules Linked to Similar Outcomes

Last Updated: April 30, 2009.

Abciximab was associated with similar outcomes compared to the small molecules eptifibatide and tirofiban in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

THURSDAY, April 30 (HealthDay News) -- Abciximab was associated with similar outcomes compared to the small molecules eptifibatide and tirofiban in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty, according to research published in the May 5 issue of the Journal of the American College of Cardiology.

Giuseppe De Luca, M.D., of the Eastern Piedmont University in Novara, Italy, and colleagues conducted a meta-analysis of six randomized trials involving 2,197 patients with STEMI who were randomized to receive abciximab, tirofiban or eptifibatide. End points included 30-day mortality, 30-day reinfarction, post-procedural Thrombolysis In Myocardial Infarction (TIMI) flow grade 3, and ST-segment resolution.

The researchers found that abciximab wasn't associated with reduced 30-day mortality or reinfarction compared with the small molecules. The drugs were linked to similar results in terms of post-procedural TIMI flow grade 3 and ST-segment resolution. In addition, major bleeding complications were similar in the two groups, the authors note.

"The information we currently possess is sufficient to guide our practice in that GPIs (glycoprotein IIb/IIIa receptor antagonists) are likely to improve outcome, compared with placebo or control therapy, particularly in high-risk STEMI patients, receiving the drug as early as possible after diagnosis and before primary percutaneous coronary intervention. The choice of GPI is more dependent on cost and considerations of reversibility rather than on efficacy, as long as drugs with similar ability to inhibit platelet aggregation are given," writes the author of an accompanying editorial.

De Luca disclosed financial relationships with Eli Lilly, Merck Sharp, and Dohme.

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