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Left ventricular function after ST-elevation myocardial infarction in patients treated with primary percutaneous coronary intervention and abciximab or tirofiban (from the Facilitated Angioplasty with Tirofiban or Abciximab [FATA] Trial)
- Source :
- The American journal of cardiology. 103(6)
- Publication Year :
- 2008
-
Abstract
- Abciximab therapy during primary percutaneous coronary intervention (PCI) has shown to ameliorate left ventricular (LV) function recovery in patients with ST elevated myocardial infarction. High-dose bolus tirofiban has similar effect on platelet inhibition. Whether this is associated with comparable efficacy on LV function recovery remains unclear. We sought to evaluate the impact on LV function of high-dose bolus tirofiban or abciximab in patients undergoing primary PCI with the predictors of favorable (or = 50%) LV ejection fraction (EF) and LV function recovery at 30 days. We studied 314 patients (abciximab n = 154; tirofiban n = 160) undergoing primary PCI in the randomized Facilitated Angioplasty with Tirofiban or Abciximab (FATA) Trial. LVEF was assessed within 48 hours and at 30 days after primary PCI. In patients with systolic dysfunction at baseline, LV function recovery was defined by either increase of LVEFor = 10% compared with baseline or LVEFor = 50%. Similar LVEF was observed in the 2 groups postprocedure (abciximab 49.7 +/- 10.1% vs tirofiban 49.3 +/- 10.1%, p = 0.9) and at 30 days (abciximab 53.1 +/- 9.8% vs tirofiban 52.5 +/- 10.2%, p = 0.6). Independent predictors of 30-day LVEFor = 50% were preprocedure Thrombolysis In Myocardial Infarction flow class0 (odds ratio = 2.4, 95% confidence interval 1.32 to 4.34), anterior location (odds ratio = 0.25, 95% confidence interval 0.15 to 0.42), and age (odds ratio = 0.97, 95% confidence interval 0.95 to 0.99). Preprocedure Thrombolysis In Myocardial Infarction flow grade0 was the only predictor of LV function recovery (odds ratio = 6.73, 95% confidence interval 2.69 to 16.88). In conclusion, this study showed no difference in LV function recovery in patients undergoing primary PCI treated either with abciximab or high-dose bolus tirofiban. Preprocedure Thrombolysis In Myocardial Infarction flow grade0 seems to be the most important predictor of favorable LVEF and LV function recovery at 30 days.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Abciximab
Myocardial Infarction
Ventricular Function, Left
Electrocardiography
Immunoglobulin Fab Fragments
Internal medicine
medicine
Humans
cardiovascular diseases
Myocardial infarction
Angioplasty, Balloon, Coronary
Aged
business.industry
ST elevation
Percutaneous coronary intervention
Antibodies, Monoclonal
Thrombolysis
Tirofiban
Middle Aged
medicine.disease
Combined Modality Therapy
Treatment Outcome
Conventional PCI
Cardiology
Tyrosine
Female
Myocardial infarction diagnosis
Cardiology and Cardiovascular Medicine
business
Platelet Aggregation Inhibitors
medicine.drug
Subjects
Details
- ISSN :
- 18791913
- Volume :
- 103
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- The American journal of cardiology
- Accession number :
- edsair.doi.dedup.....8b90415e8d0d081520b74069550dc835