J Transcat Intervent.2018;26(1-2):eA0017.
Use of platelet glycoprotein IIb/IIIa inhibitors in primary percutaneous coronary intervention: 10-year experience in Brazil
DOI: 10.31160/JOTCI2018;26(2)A0017
ABSTRACT
Background
Individualized use of glycoprotein IIb/IIIa inhibitors during primary percutaneous coronary intervention in scenarios with high thrombotic load or occurrence of coronary flow abnormalities may be considered, despite scarce scientific evidence. Our objective was to compare patients undergoing primary percutaneous coronary intervention treated or not with glycoprotein IIb/IIIa inhibitors during the procedure.
Methods
A national, multicenter, retrospective study that included consecutive patients undergoing primary percutaneous coronary intervention, treated or not with glycoprotein IIb/IIIa inhibitors, between June 2006 and March 2016, using the database of the Central Nacional de Intervenções Cardiovasculares (CENIC).
Results
We enrolled 18,690 patients, of which 3,032 (16.2%) received glycoprotein IIb/IIIa inhibitors. The mean age was 61.5±12.4 years, 69.5% were men, and 19.9% had diabetes mellitus. The group receiving glycoprotein IIb/IIIa inhibitors had a higher prevalence of long, thrombotic, bifurcation lesions, occlusions or TIMI flow grade <2. This group showed higher mortality (3.7% vs. 4.8%; p=0.0046), reinfarction (0.5% vs. 1.1%; p<0.0001) and major adverse cardiac event rates (4.0% vs. 5.7%; p<0.0001). In the univariate analysis, the use of glycoprotein IIb/IIIa inhibitors was associated with a higher chance of death (RR 1.31; 95%CI 1.09-1.58; p=0.0048), but was not confirmed as an independent predictor in the multivariate analysis.
Conclusion
Among patients undergoing primary percutaneous coronary intervention, the group treated with glycoprotein IIb/IIIa inhibitors had greater clinical severity and anatomical complexity, and worse in-hospital clinical outcomes.
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