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  • Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. We compared a strategy of early, routine administration of eptifibatide with delayed, provisional administration in 9492 patients who had acute coronary syndromes without ST-segment elevation and who were assigned to an invasive strategy. Patients were randomly assigned to receive either early eptifibatide (two boluses, each containing 180 mu g per kilogram of body weight, administered 10 minutes apart, and a standard infusion >= 12 hours before angiography) or a matching placebo infusion with provisional use of eptifibatide after angiography (delayed eptifibatide). The primary efficacy end point was a composite of death, myocardial infarction, recurrent ischemia requiring urgent revascularization, or the occurrence of a thrombotic complication during percutaneous coronary intervention that required bolus therapy opposite to the initial study-group assignment (%22thrombotic bailout%22) at 96 hours. The key secondary end point was a composite of death or myocardial infarction within the first 30 days. Key safety end points were bleeding and the need for transfusion within the first 120 hours after randomization. The primary end point occurred in 9.3% of patients in the early-eptifibatide group and in 10.0% in the delayed-eptifibatide group (odds ratio, 0.92; 95% confidence interval [CI], 0.80 to 1.06; P = 0.23). At 30 days, the rate of death or myocardial infarction was 11.2% in the early-eptifibatide group, as compared with 12.3% in the delayed-eptifibatide group (odds ratio, 0.89; 95% CI, 0.79 to 1.01; P = 0.08). Patients in the early-eptifibatide group had significantly higher rates of bleeding and red-cell transfusion. There was no significant difference between the two groups in rates of severe bleeding or nonhemorrhagic serious adverse events. In patients who had acute ...
  • Glycoprotein IIb/IIIa inhibitors are indicated in patients with acute coronary syndromes who are undergoing an invasive procedure. The optimal timing of the initiation of such therapy is unknown. We compared a strategy of early, routine administration of eptifibatide with delayed, provisional administration in 9492 patients who had acute coronary syndromes without ST-segment elevation and who were assigned to an invasive strategy. Patients were randomly assigned to receive either early eptifibatide (two boluses, each containing 180 mu g per kilogram of body weight, administered 10 minutes apart, and a standard infusion >= 12 hours before angiography) or a matching placebo infusion with provisional use of eptifibatide after angiography (delayed eptifibatide). The primary efficacy end point was a composite of death, myocardial infarction, recurrent ischemia requiring urgent revascularization, or the occurrence of a thrombotic complication during percutaneous coronary intervention that required bolus therapy opposite to the initial study-group assignment (%22thrombotic bailout%22) at 96 hours. The key secondary end point was a composite of death or myocardial infarction within the first 30 days. Key safety end points were bleeding and the need for transfusion within the first 120 hours after randomization. The primary end point occurred in 9.3% of patients in the early-eptifibatide group and in 10.0% in the delayed-eptifibatide group (odds ratio, 0.92; 95% confidence interval [CI], 0.80 to 1.06; P = 0.23). At 30 days, the rate of death or myocardial infarction was 11.2% in the early-eptifibatide group, as compared with 12.3% in the delayed-eptifibatide group (odds ratio, 0.89; 95% CI, 0.79 to 1.01; P = 0.08). Patients in the early-eptifibatide group had significantly higher rates of bleeding and red-cell transfusion. There was no significant difference between the two groups in rates of severe bleeding or nonhemorrhagic serious adverse events. In patients who had acute ... (en)
Title
  • Early versus delayed, provisional eptifibatide in acute coronary syndromes
  • Early versus delayed, provisional eptifibatide in acute coronary syndromes (en)
skos:prefLabel
  • Early versus delayed, provisional eptifibatide in acute coronary syndromes
  • Early versus delayed, provisional eptifibatide in acute coronary syndromes (en)
skos:notation
  • RIV/00843989:_____/09:00103109!RIV13-MZ0-00843989
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • N
http://linked.open...iv/cisloPeriodika
  • 21
http://linked.open...vai/riv/dodaniDat
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http://linked.open...iv/duvernostUdaju
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  • 311780
http://linked.open...ai/riv/idVysledku
  • RIV/00843989:_____/09:00103109
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • ST-segment elevation; platelet glycoprotein IIB/IIIA; placebo controlled trial; unstable angina; clinical outcomes; randomized trial; myocardial infarction; medical therapy; task force; intervention (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [C5F2F66BD36A]
http://linked.open...i/riv/nazevZdroje
  • New England Journal of Medicine
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 360
http://linked.open...iv/tvurceVysledku
  • Harrington, R. A.
  • Lewis, B. S.
  • Van de Werf, F.
  • Štípal, Roman
  • Califf, R. M.
  • Bode, Ch.
  • Braunwald, E.
  • Pleva, Leoš
  • Montalescot, G.
  • Armstrong, P. W.
  • Berdan, L. G.
  • Giugliano, R. P.
  • Hildemann, S.
  • Lee, K. L.
  • Newby, L. K.
  • Strony, J. T.
  • Veltri, E.
  • White, J. A
  • van´t Hof, A.
http://linked.open...ain/vavai/riv/wos
  • 000266206000005
issn
  • 0028-4793
number of pages
http://bibframe.org/vocab/doi
  • 10.1056/NEJMoa0901316
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