title: Three-year follow-up of the MULTIcentre evaluation of Single high-dose Bolus TiRofiban versus Abciximab with Sirolimus-eluting STEnt or Bare-Metal Stent in Acute Myocardial Infarction StudY (MULTISTRATEGY).
abstract: BACKGROUND
  The Multicentre Evaluation of Single high-dose Bolus TiRofiban versus Abciximab with Sirolimus-eluting Stent or Bare Metal Stent in Acute Myocardial Infarction Study [MULTISTRATEGY]) randomised 745 patients with ST-elevation myocardial infarction to receive high-dose bolus (HDB) tirofiban or abciximab infusion and sirolimus-eluting (SES) or uncoated-stent (BMS) implantation. Tirofiban was non-inferior to abciximab in terms of ST-segment resolution after intervention, whereas 8 month-major adverse cardiac events occurred in 14.5% in the BMS and 7.8% in the SES groups (P = 0.0039), reflecting a reduction of reintervention rates (10.2% vs. 3.2%). A three-year follow-up was performed to extend previous short- to mid-term findings.
  
  
  RESULTS
  Complete data at 3 years was available for 736 patients (99%). All-cause mortality was 6.7% in the tirofiban and 7.8% in the abciximab (P = 0.56) and 7.5% in the BMS vs 7.0 in the SES groups, P = 0.79. The composite of all-cause death or MI was identical at 12.9% in tirofiban and abciximab groups, P = 0.99 and it occurred in 13.2% in the BMS vs. 12.6% in the SES groups (P = 0.83). The need for reintervention remained more than twice as common with BMS (13.7%; versus 6.2%, P = 0.0006). The cumulative rate of stent thrombosis (ST) did not differ. This is inspite of a higher very late definite, probable or possible ST thrombosis rate in the SES group.
  
  
  CONCLUSIONS
  The 3-year follow-up of MULTISTRATEGY demonstrated comparable outcomes with HDB Tirofiban or abciximab and a sustained efficacy of SES to reduce reintervention with no difference in death, repeat MI or ST.
authors.affiliation: Cardiovascular Institute, University of Ferrara, Italy. vlgmrc@unife.it
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
authors.forename: Stefania
authors.initials: S
authors.lastname: Gambetti
authors.forename: Leonardo
authors.initials: L
authors.lastname: Bolognese
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Salvatore
authors.initials: S
authors.lastname: Colangelo
authors.forename: Nicoletta
authors.initials: N
authors.lastname: de Cesare
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Rodriguez
authors.forename: Filippo
authors.initials: F
authors.lastname: Russo
authors.forename: Raul
authors.initials: R
authors.lastname: Moreno
authors.forename: Tommaso
authors.initials: T
authors.lastname: Piva
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Carlo
authors.initials: C
authors.lastname: Penzo
authors.forename: Francesco
authors.initials: F
authors.lastname: Prati
authors.forename: Marco S
authors.initials: MS
authors.lastname: Nazzaro
authors.forename: José F
authors.initials: JF
authors.lastname: Díaz Fernández
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
authors.forename: Giovanni
authors.initials: G
authors.lastname: Parrinello
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
mesh_terms: D000077284:Abciximab; D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D054855:Drug-Eluting Stents / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D008297:Male; D008670:Metals; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D011446:Prospective Studies; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000639:trends; D000077466:Tirofiban; D016896:Treatment Outcome; D014443:Tyrosine / Q000008:administration & dosage / Q000031:analogs & derivatives*
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D008670:Metals; D014443:Tyrosine; D000077466:Tirofiban; D020123:Sirolimus; D000077284:Abciximab