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 language | English |
|---|---|
| Pages (from-to) | 405-413 |
| Number of pages | 9 |
| Journal | Circulation Journal |
| Volume | 76 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2012 Jan 31 |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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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 journal › Article
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.
UR - http://www.scopus.com/inward/record.url?scp=84863082487&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863082487&partnerID=8YFLogxK
U2 - 10.1253/circj.CJ-11-0676
DO - 10.1253/circj.CJ-11-0676
M3 - Article
C2 - 22146757
AN - SCOPUS:84863082487
VL - 76
SP - 405
EP - 413
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 2
ER -