Effectiveness of early coronary angioplasty and abciximab for failed thrombolysis (reteplase or alteplase) during acute myocardial infarction (results from the GUSTO-III trial). Global Use of Strategies To Open occluded coronary arteries.
Research article published in The American journal of cardiology (1999)
Abstract
We evaluated the effects of abciximab treatment during early angioplasty after clinically failed thrombolysis for acute myocardial infarction. In the Global Use of Strategies To Open occluded coronary arteries (GUSTO-III) trial of reteplase versus alteplase for acute infarction (n = 15,059), 392 patients underwent angioplasty a median of 3.5 hours after thrombolysis and had complete procedural data. We compared 30-day mortality and in-hospital outcomes between patients who received abciximab (n = 83) and those who did not (n = 309), and (among patients given abciximab) between those randomized to alteplase versus reteplase. Patients given abciximab had anterior infarction less often, but were more often in Killip classes III or IV. The 30-day mortality rate tended to be lower with abciximab (3.6% vs 9.7%, p = 0.076), more so after adjustment for baseline differences (p = 0.042). The composite of death, stroke, or reinfarction did not differ significantly with abciximab treatment (12% vs 14%, p = 0.7), but it occurred less often among abciximab-treated patients who had been randomized to reteplase (n = 55) versus alteplase (n = 28) (7% vs 21%, p = 0.08). Severe bleeding was increased among abciximab-treated patients (3.6% vs 1.0%, p = 0.08), despite less heparin use. No intracranial hemorrhages occurred with abciximab. The use of abciximab for early angioplasty after clinically failed thrombolysis resulted in trends toward lower 30-day mortality and increased bleeding.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
We evaluated the effects of abciximab treatment during early angioplasty after clinically failed thrombolysis for acute myocardial infarction.
Por qué esto importa para la hirudoterapia
Este análisis observacional de subgrupos del ensayo GUSTO-III examinó a 392 pacientes que se sometieron a angioplastia tras una trombólisis clínica fallida para un infarto agudo de miocardio, comparando a los que recibieron el inhibidor de plaquetas GPIIb/IIIa abciximab (n=83) con los que no recibieron (n=309); el uso de abciximab estuvo asociado con una tendencia hacia una menor mortalidad a los 30 días (3.6% vs 9.7%, p=0.076; p=0.042 después del ajuste) pero también aumentó la hemorragia grave (3.6% vs 1.0%, p=0.08). Para ASH, es evidencia contextual sobre cómo los agentes antitrombóticos/antiplaquetarios intercambian el beneficio isquémico contra el riesgo de sangrado, el mismo equilibrio terapéutico que define los componentes antiplaquetarios y anticoagulantes del secretoma de la sanguijuela medicinal. Advertencia: esta es una comparación retrospectiva de subgrupos no aleatorizada (abciximab no fue asignado aleatoriamente), las diferencias fueron mayormente tendencias estadísticas, y no tiene conexión directa con las sanguijuelas o la hirudoterapia más allá de la farmacología antitrombótica compartida.
Citación
Effectiveness of early coronary angioplasty and abciximab for failed thrombolysis (reteplase or alteplase) during acute myocardial infarction (results from the GUSTO-III trial). Global Use of Strategies To Open occluded coronary arteries.
Miller JM et al. · The American journal of cardiology, 1999
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026