Stenting and glycoprotein IIb/IIIa inhibition in patients with acute myocardial infarction undergoing percutaneous coronary intervention: findings from the global registry of acute coronary events (GRACE).
Stenting and GP IIb/IIIa inhibition are promising adjunctive therapies in PCI. The Global Registry of Acute Coronary Events (GRACE) is a registry of unselected patients with acute coronary syndromes, allowing for the study of treatments in a real-world environment. Data from GRACE patients with AMI who underwent PCI were analyzed. After adjusting for demographics, baseline characteristics, and previous medications, treatment with GP IIb/IIIa inhibitors and a stent and treatment with a stent alone were significant predictors of survival at 6 months. Stents were used in 90.9% of patients. GP IIb/IIIa inhibitors were used in 59.7%; in most cases they were started after the beginning of the procedure. The in-hospital death rate (7.6%) was highest in patients undergoing urgent PCI. Mortality at 6 months following PCI was 14.4% among patients who received neither GP IIb/IIIa inhibitors nor a stent, compared to patients who received both GP IIb/IIIa inhibitors and a stent (7.3%), GP IIb/IIIa inhibitors alone (12.8%), or a stent alone (6.7%).
Service de Cardiologie, Pitié-Salpêtrière Hospital, Paris, France. gilles.montalescot@psl.ap-hop-paris.fr
Gilles
G
Montalescot
Frans
F
Van de Werf
Dietrich C
DC
Gulba
Alvaro
A
Avezum
David
D
Brieger
Brian M
BM
Kennelly
Tomasz
T
Mazurek
Frederick
F
Spencer
Kami
K
White
Joel M
JM
Gore
D000328:Adult; D000368:Aged; D000569:Americas / Q000453:epidemiology; D015906:Angioplasty, Balloon, Coronary; D001315:Australia / Q000453:epidemiology; D019917:Blood Vessel Prosthesis Implantation; D003131:Combined Modality Therapy; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology / Q000628:therapy; D005060:Europe / Q000453:epidemiology; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000628:therapy*; D009520:New Zealand / Q000453:epidemiology; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors* / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012042:Registries; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D019039:Platelet Glycoprotein GPIIb-IIIa Complex