May 25, 2010European Heart Journal
Use of glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: insights from the APEX-AMI trial
Why the study?
Does pre-sheath administration of glycoprotein IIb/IIIa inhibitors reduce 90-day mortality in STEMI patients undergoing primary PCI compared to in-lab administration?
Population
5,707 patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention…
Comparison
Pre-sheath administration of glycoprotein… vs In-lab administration of glycoprotein IIb/IIIa…
Design
Cohort
Follow-up
90 days
Authors
Discussion
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Member takes
Implication
Does not support routine pre-sheath GPI use in primary PCI; leaves open whether RCTs confirm the mortality association.
Structured PICO
Does pre-sheath administration of glycoprotein IIb/IIIa inhibitors reduce 90-day mortality in STEMI patients undergoing primary PCI compared to in-lab administration?
P
Population
5,707 patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) from the APEX-AMI trial cohort.
I
Intervention
Pre-sheath administration of glycoprotein IIb/IIIa inhibitors (abciximab, eptifibatide, or tirofiban) prior to arriving in the catheterization laboratory (n=1,125).
C
Comparator
In-lab administration of glycoprotein IIb/IIIa inhibitors after arrival in the catheterization laboratory (n=2,844).
O
Outcome
90-day mortalityhard clinical
Pre-procedural administration of glycoprotein IIb/IIIa inhibitors in STEMI patients undergoing primary PCI is associated with reduced 90-day mortality.
Limitations
- Retrospective analysis
Cite This Study
Huber et al. (2010) studied this question.