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- Title
Routine Upstream Initiation vs Deferred Selective Use of Glycoprotein llb/llla Inhibitors in Acute Coronary Syndromes.
- Authors
Stone, Gregg W.; Bertrand, Michel E.; Moses, Jeffrey W.; Ohman, E. Magnus; Lincoff, A. Michael; Ware, James H.; Pocock, Stuart J.; McLaurin, Brent T.; Cox, David A.; Jafar, M. Zubair; Chandna, Harish; Hartmann, Fraz; Leisch, Franz; Strasser, Ruth H.; Desaga, Martin; Stuckey, Thomas D.; Zelman, Richard B.; Lieber, Ira H.; Cohen, David J.; Mehran, Roxana
- Abstract
The authors present the results of their randomized study to determine the best strategy for the use of glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors in patients with moderate and high risk acute coronary syndromes about to undergo an early, invasive treatment. Current guidelines recommend administration of Gp IIb/IIIa inhibitors either upstream to all patients before an angiography or selectively in the catheterization lab just prior to the procedure, but do not specify either approach. Deferring Gp IIb/IIIa administration for patients undergoing percutaneous coronary intervention resulted in an increase in composite ischemia that did not meet the criterion for noninferiority as well as a reduction in bleeding.
- Subjects
GLYCOPROTEINS; DRUG administration; ISCHEMIA prevention; HEMORRHAGE prevention; ANGIOGRAPHY; DECISION making in clinical medicine; BLOOD circulation disorders; CARDIOVASCULAR diseases; THERAPEUTICS
- Publication
JAMA: Journal of the American Medical Association, 2007, Vol 297, Issue 6, p591
- ISSN
0098-7484
- Publication type
Article
- DOI
10.1001/jama.297.6.591