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, Myeongki 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

Research output: Contribution to journalArticle

5 Citations (Scopus)

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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clopidogrel
Myocardial Infarction
Percutaneous Coronary Intervention
Hospital Emergency Service
Republic of Korea
Platelet Glycoprotein GPIIb-IIIa Complex
Stroke
Odds Ratio
ST Elevation Myocardial Infarction
abciximab
Confidence Intervals
Hemorrhage
Safety
Incidence
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Jung Sun ; Park, Sang Min ; Kim, Byeong Keuk ; Ko, Young Guk ; Choi, Donghoon ; Hong, Myeongki ; Seong, In Whan ; Kim, Byung Ok ; Gwon, Hyeon Cheol ; Hong, Bum Kee ; Tahk, Seung Jae ; Park, Seong Wook ; Kim, Chong Jin ; Jeong, Myung Ho ; Yoon, Junghan ; Jang, Yangsoo. / Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI). In: Circulation Journal. 2012 ; Vol. 76, No. 2. pp. 405-413.
@article{043986762daf40d5bae802d31d05af0a,
title = "Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI)",
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.",
author = "Kim, {Jung Sun} and Park, {Sang Min} and Kim, {Byeong Keuk} and Ko, {Young Guk} and Donghoon Choi and Myeongki Hong and Seong, {In Whan} and Kim, {Byung Ok} and Gwon, {Hyeon Cheol} and Hong, {Bum Kee} and Tahk, {Seung Jae} and Park, {Seong Wook} and Kim, {Chong Jin} and Jeong, {Myung Ho} and Junghan Yoon and Yangsoo Jang",
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month = "1",
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Kim, JS, Park, SM, Kim, BK, Ko, YG, Choi, D, Hong, M, Seong, IW, Kim, BO, Gwon, HC, Hong, BK, Tahk, SJ, Park, SW, Kim, CJ, Jeong, MH, Yoon, J & Jang, Y 2012, 'Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI)', Circulation Journal, vol. 76, no. 2, pp. 405-413. https://doi.org/10.1253/circj.CJ-11-0676

Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI). / Kim, Jung Sun; Park, Sang Min; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Hong, Myeongki; Seong, In Whan; Kim, Byung Ok; Gwon, Hyeon Cheol; Hong, Bum Kee; Tahk, Seung Jae; Park, Seong Wook; Kim, Chong Jin; Jeong, Myung Ho; Yoon, Junghan; Jang, Yangsoo.

In: Circulation Journal, Vol. 76, No. 2, 31.01.2012, p. 405-413.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Efficacy of clotinab in acute myocardial infarction trial-ST elevation myocardial infarction (ECLAT-STEMI)

AU - Kim, Jung Sun

AU - Park, Sang Min

AU - Kim, Byeong Keuk

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeongki

AU - Seong, In Whan

AU - Kim, Byung Ok

AU - Gwon, Hyeon Cheol

AU - Hong, Bum Kee

AU - Tahk, Seung Jae

AU - Park, Seong Wook

AU - Kim, Chong Jin

AU - Jeong, Myung Ho

AU - Yoon, Junghan

AU - Jang, Yangsoo

PY - 2012/1/31

Y1 - 2012/1/31

N2 - 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.

AB - 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.

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