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)
Center for Outcomes Research; Department of Medicine, Division of Cardiovascular Medicine
Medical Subject Headings
Adult; Aged; Americas; *Angioplasty, Balloon, Coronary; Australia; Blood Vessel Prosthesis Implantation; Combined Modality Therapy; Coronary Artery Bypass; Coronary Disease; Europe; Female; Fibrinolytic Agents; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction; New Zealand; Platelet Glycoprotein GPIIb-IIIa Complex; inhibitors; Postoperative Complications; Registries; Risk Factors; *Stents; Time Factors; Treatment Outcome
Health Services Research
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%).
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Citation: Catheter Cardiovasc Interv. 2003 Nov;60(3):360-7. Link to article on publisher's site