Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI)

Jung Sun Kim, Sang Min Park, Byeong Keuk Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, In Whan Seong, Byung Ok Kim, Hyeon Cheol Gwon, Bum Kee Hong, Seung Jae Tahk, Seong Wook Park, Chong Jin Kim, Myung Ho Jeong, Junghan Yoon, Yangsoo Jang

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Abstract

Background: This study investigated the efficacy and the safety of the upstream glycoprotein (Gp) IIb/IIIa inhibitor (clotinab; ISU ABXIS, Seoul, Republic of Korea) under 600-mg clopidogrel pretreatment compared with provisional use in ST-elevation myocardial infarction (STEMI). Methods and Results: A total of 786 STEMI patients were randomized to upstream use in the emergency room (ER) (n=392) or provisional use during percutaneous coronary intervention (PCI) (n=394). All patients were prescribed 600-mg clopidogrel in the ER. The primary endpoint was the 30-day incidence of composite events including death, nonfatal myocardial infarction, target vessel revascularization, and stroke. There was no significant difference in the events that occurred in 40 patients (10.2%) in the upstream arm and 55 patients (14.0%) in the provisional arm during the 30 days (odds ratio 0.70, 95% confidence interval 0.45-1.08). Major bleeding was higher in the upstream arm (1.5% vs. 0%, P=0.02). However, there was a significant reduction in 30-day composite events in the upstream arm in the high-risk population (Killip class ≥II or GRACE score >140). Conclusions: The upstream use of clotinab under a 600-mg clopidogrel loading may not significantly reduce cardiac events following primary PCI but may improve the clinical outcome in high-risk patients.

Original languageEnglish
Pages (from-to)405-413
Number of pages9
JournalCirculation Journal
Volume76
Issue number2
DOIs
Publication statusPublished - 2012 Jan 31

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, J. S., Park, S. M., Kim, B. K., Ko, Y. G., Choi, D., Hong, M. K., Seong, I. W., Kim, B. O., Gwon, H. C., Hong, B. K., Tahk, S. J., Park, S. W., Kim, C. J., Jeong, M. H., Yoon, J., & Jang, Y. (2012). Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI). Circulation Journal, 76(2), 405-413. https://doi.org/10.1253/circj.CJ-11-0676