PMID- 12242074
OWN - NLM
STAT- MEDLINE
DCOM- 20030115
LR  - 20190513
IS  - 0195-668X (Print)
IS  - 0195-668X (Linking)
VI  - 23
IP  - 19
DP  - 2002 Oct
TI  - Safety and efficacy of abciximab combined with dalteparin in treatment of acute 
      coronary syndromes.
PG  - 1538-45
AB  - AIMS: The safety and efficacy of abciximab in addition to 
      low-molecular-weight-heparin as the primary medical treatment of acute coronary 
      syndromes has not previously been investigated. METHODS AND RESULTS: The GUSTO 
      IV-ACS trial included 7800 patients with chest pain and either ST-segment 
      depression or a positive troponin test. They were randomized to abciximab for 24 
      h, 48 h or placebo. In the dalteparin substudy, 974 patients received 5 days of 
      s.c. dalteparin, instead of a 48 h infusion of unfractionated heparin (UFH). 
      Major and minor bleedings were more frequent for abciximab (24 and 48 h combined) 
      than placebo both in the dalteparin (abciximab 5.0% vs placebo 1.8% P<0.05) and 
      in the UFH cohort (3.8% vs 1.8% P<0.001). However, stroke rates were low, < or = 
      0.6%. At 30 days there were no significant differences in the rate of death or 
      MI, either in the dalteparin (abciximab 9.6% vs placebo 11.3%: O.R. 0.85; 95% 
      C.I. 0.58-1.25) or in the UFH cohort (8.5% vs 7.6%: O.R.; 1.12: 0.95-1.34). 
      CONCLUSION: Treatment with abciximab, aspirin and s.c. dalteparin is associated 
      with a low risk of major side effects and is as safe as the combination of 
      abciximab and UFH. Without early coronary intervention there is no indication for 
      abciximab treatment.
CI  - Copyright 2002 The European Society of Cardiology
FAU - James, S
AU  - James S
AD  - Department of Cardiology, Thoraxcenter, Academic Hospital, Uppsala, Sweden.
FAU - Armstrong, P
AU  - Armstrong P
FAU - Califf, R
AU  - Califf R
FAU - Husted, S
AU  - Husted S
FAU - Kontny, F
AU  - Kontny F
FAU - Niemminen, M
AU  - Niemminen M
FAU - Pfisterer, M
AU  - Pfisterer M
FAU - Simoons, M L
AU  - Simoons ML
FAU - Wallentin, L
AU  - Wallentin L
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - England
TA  - Eur Heart J
JT  - European heart journal
JID - 8006263
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Anticoagulants)
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - S79O08V79F (Dalteparin)
RN  - X85G7936GV (Abciximab)
SB  - IM
MH  - Abciximab
MH  - Acute Disease
MH  - Aged
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Anticoagulants/*therapeutic use
MH  - Cohort Studies
MH  - Coronary Disease/complications/*drug therapy/epidemiology
MH  - Cross-Over Studies
MH  - Dalteparin/*therapeutic use
MH  - Double-Blind Method
MH  - Drug Evaluation
MH  - Drug Therapy, Combination
MH  - Europe/epidemiology
MH  - Female
MH  - Follow-Up Studies
MH  - Hemorrhage/epidemiology/etiology
MH  - Heparin, Low-Molecular-Weight/*therapeutic use
MH  - Humans
MH  - Immunoglobulin Fab Fragments/*therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*therapeutic use
MH  - Risk Factors
MH  - Safety
MH  - Stroke/epidemiology/etiology
MH  - Syndrome
MH  - Thrombocytopenia/epidemiology/etiology
MH  - Treatment Outcome
MH  - United States/epidemiology
EDAT- 2002/09/21 10:00
MHDA- 2003/01/16 04:00
CRDT- 2002/09/21 10:00
PHST- 2002/09/21 10:00 [pubmed]
PHST- 2003/01/16 04:00 [medline]
PHST- 2002/09/21 10:00 [entrez]
AID - S0195668X02932574 [pii]
AID - 10.1053/euhj.2002.3257 [doi]
PST - ppublish
SO  - Eur Heart J. 2002 Oct;23(19):1538-45. doi: 10.1053/euhj.2002.3257.