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).
  
  
  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.
authors.affiliation: Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Republic of Korea.
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Kim
authors.forename: Sang-Min
authors.initials: SM
authors.lastname: Park
authors.forename: Byeong-Keuk
authors.initials: BK
authors.lastname: Kim
authors.forename: Young-Guk
authors.initials: YG
authors.lastname: Ko
authors.forename: Donghoon
authors.initials: D
authors.lastname: Choi
authors.forename: Myeong-Ki
authors.initials: MK
authors.lastname: Hong
authors.forename: In Whan
authors.initials: IW
authors.lastname: Seong
authors.forename: Byung Ok
authors.initials: BO
authors.lastname: Kim
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
authors.forename: Bum Kee
authors.initials: BK
authors.lastname: Hong
authors.forename: Seung-Jae
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Seong-Wook
authors.initials: SW
authors.lastname: Park
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Junghan
authors.initials: J
authors.lastname: Yoon
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
mesh_terms: D000077284:Abciximab; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D004562:Electrocardiography; D004632:Emergency Medical Services / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab