Key result
Lamifiban speeds STEMI reperfusion but increases bleeding requiring transfusions by ~56% versus placebo.
Why the study?
Early complete reperfusion improves survival in acute myocardial infarction, and GP IIb/IIIa blockade may speed reperfusion when combined with thrombolytic therapy.
Does lamifiban added to thrombolysis improve reperfusion in patients with ST segment elevation acute myocardial infarction?
Population
Patients with ST segment elevation acute myocardial infarction presenting within 12 h of symptom onset treated with thrombolysis
Comparison
Lamifiban bolus plus 24-h infusion vs placebo
Design
Three-part Phase II dose exploration study including randomized, double-blind comparison
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Accelerates ECG reperfusion but increases bleeding; leaves open net clinical benefit of lamifiban added to thrombolysis.
RCT
Double-blind
2:1 ratio
Does lamifiban added to thrombolysis improve reperfusion in patients with ST segment elevation acute myocardial infarction?
Absolute Event Rate: 16.1% vs 10.3%
Adding the GP IIb/IIIa inhibitor lamifiban to thrombolysis for STEMI improves ECG markers of reperfusion but increases bleeding risk without obvious clinical benefit in this phase II trial.
A 1998 study conducted an RCT in ST segment elevation acute myocardial infarction. Lamifiban vs. Placebo was evaluated on Composite of angiographic, continuous electrocardiographic and clinical markers of reperfusion (efficacy) and bleeding (safety). Lamifiban given with thrombolytic therapy for STEMI induced more rapid reperfusion but increased bleeding requiring transfusions (16.1% vs 10.3% with placebo).
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