title: Comparison of 1-year Major Adverse Cardiac Events in Patients Undergoing Primary Percutaneous Coronary Intervention Receiving Intracoronary Bolus Only Versus Intracoronary Bolus Plus Infusion of Glycoprotein IIb/IIIa Inhibitors.
abstract: The aim of this study is to compare intracoronary (IC) bolus only with IC bolus plus maintenance intravenous (IV) infusion of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors with respect to 1-year major adverse cardiac events including mortality, nonfatal myocardial infarction, revascularization, and bleeding events after primary percutaneous coronary intervention (PCI).
  
  
  
  This is an observational study of 233 consecutive patients who presented with ST-elevation myocardial infarction and underwent primary PCI between April 2009 and December 2012. Patients were grouped into (1) patients who received IC bolus only (n = 102) and (2) patients who received IC bolus plus maintenance IV infusion of GP IIb/IIIa inhibitors (n = 131). In-hospital post procedural myocardial infarction occurred in 4 (1.7 %) of patients.
  
  
  
  Mortality occurred in one patient who was treated with IV infusion. Major bleeding occurred in only 5 patients, among whom 4 patients had received GP IIb/IIIa inhibitors IV infusion. However, the difference was not statistically significant (P = 0.389).
  
  
  
  Both univariate analysis and the adjusted model for the potential confounders revealed no significant association between the way of GP IIb/IIIa inhibitors administration and 1-year major adverse cardiac events. Our findings suggested that IV infusion of GP IIb/IIIa inhibitors after the bolus dose is not associated with better 1-year outcome after adjustment for confounding variables. Moreover, IV infusion may increase the risk of major bleedings after primary PCI. This finding implies that the need for IV infusion of GP IIb/IIIa inhibitors in patients undergoing primary PCI is under question.
authors.affiliation: From the *Department of Interventional Cardiology, and †Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Seyed Ebrahim
authors.initials: SE
authors.lastname: Kassaian
authors.forename: Yadollah
authors.initials: Y
authors.lastname: Fathi
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Lotfi-Tokaldany
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Salarifar
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alidoosti
authors.forename: Ali-Mohammad
authors.initials: AM
authors.lastname: Haji-Zeinali
authors.forename: Hassan
authors.initials: H
authors.lastname: Aghajani
authors.forename: Alireza
authors.initials: A
authors.lastname: Amirzadegan
authors.forename: Younes
authors.initials: Y
authors.lastname: Nozari
authors.forename: Seyedeh Hamideh
authors.initials: SH
authors.lastname: Mortazavi
authors.forename: Arash
authors.initials: A
authors.lastname: Jalali
authors.forename: Sepideh
authors.initials: S
authors.lastname: Saroukhani
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000037:antagonists & inhibitors*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D019039:Platelet Glycoprotein GPIIb-IIIa Complex