PMID- 14522476
OWN - NLM
STAT- MEDLINE
DCOM- 20031017
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 42
IP  - 7
DP  - 2003 Oct 1
TI  - Outcome of urgent and elective percutaneous coronary interventions after 
      pharmacologic reperfusion with tenecteplase combined with unfractionated heparin, 
      enoxaparin, or abciximab.
PG  - 1178-85
AB  - OBJECTIVES: The aim of this study was to evaluate percutaneous coronary 
      intervention (PCI) in the Assessment of the Safety and Efficacy of New 
      Thrombolytic Regimens (ASSENT-3) trial. BACKGROUND: In the ASSENT-3 trial, 
      co-therapy with abciximab (ABC) or enoxaparin (ENOX) reduced ischemic 
      complications after ST-elevation acute myocardial infarction treated with 
      tenecteplase when compared with unfractionated heparin (UFH). The effect of these 
      new co-therapies on the results of PCI is unknown. METHODS: Clinical outcomes in 
      patients who received co-therapy with ABC, ENOX, or UFH and subsequently 
      underwent an elective (n = 1,064) or urgent (n = 716) PCI in the ASSENT-3 trial 
      were compared. RESULTS: No significant differences in clinical end points were 
      observed in patients who underwent an elective PCI. A non-significant trend 
      toward fewer in-hospital myocardial re-infarctions was seen with ABC and ENOX 
      when compared with UFH (0.5% vs. 0.6% vs. 1.5%, respectively). The incidence of 
      bleeding complications was similar in the three treatment arms. Significantly 
      fewer ABC- and ENOX-treated patients needed urgent PCI compared with UFH (9.1% 
      vs. 11.9% vs. 14.3%; p < 0.0001), but outcomes in these patients were in general 
      less favorable (30-day mortality: 8.2% vs. 5.4% vs. 4.5%; 1-year mortality: 11.0% 
      vs. 8.5% vs. 5.6%; in-hospital re-infarction: 3.9% vs. 2.5% vs. 2.7%; major 
      bleeding complications: 8.8% vs. 7.0% vs. 3.4%). In pairwise comparisons with 
      UFH, the higher one-year mortality and major bleeding rates after ABC were 
      statistically significant (p = 0.045 and p = 0.012, respectively). CONCLUSIONS: 
      Clinical outcomes after elective PCI were similar with the three antithrombotic 
      co-therapies studied in ASSENT-3. Although fewer patients needed urgent PCI with 
      ABC and ENOX, clinical outcomes were less favorable in this selected population, 
      especially with ABC.
FAU - Dubois, Christophe L
AU  - Dubois CL
AD  - Department of Cardiology, University Hospitals Leuven, Leuven, Belgium
FAU - Belmans, Ann
AU  - Belmans A
FAU - Granger, Christopher B
AU  - Granger CB
FAU - Armstrong, Paul W
AU  - Armstrong PW
FAU - Wallentin, Lars
AU  - Wallentin L
FAU - Fioretti, Paolo M
AU  - Fioretti PM
FAU - Lopez-Sendon, Jose L
AU  - Lopez-Sendon JL
FAU - Verheugt, Freek W
AU  - Verheugt FW
FAU - Meyer, Jurgen
AU  - Meyer J
FAU - Van de Werf, Frans
AU  - Van de Werf F
CN  - ASSENT-3 Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Anticoagulants)
RN  - 0 (Enoxaparin)
RN  - 0 (Fibrinolytic Agents)
RN  - 0 (Immunoglobulin Fab Fragments)
RN  - 0 (Platelet Glycoprotein GPIIb-IIIa Complex)
RN  - 9005-49-6 (Heparin)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - WGD229O42W (Tenecteplase)
RN  - X85G7936GV (Abciximab)
SB  - IM
CIN - J Am Coll Cardiol. 2003 Oct 1;42(7):1186-7. PMID: 14522477
MH  - Abciximab
MH  - Alberta
MH  - *Angioplasty, Balloon, Coronary
MH  - Antibodies, Monoclonal/administration & dosage
MH  - Anticoagulants/administration & dosage
MH  - Belgium
MH  - Drug Administration Schedule
MH  - Drug Therapy, Combination
MH  - Elective Surgical Procedures
MH  - Emergency Treatment
MH  - Enoxaparin/administration & dosage
MH  - Female
MH  - Fibrinolytic Agents/*administration & dosage
MH  - Germany
MH  - Heparin/administration & dosage
MH  - Humans
MH  - Immunoglobulin Fab Fragments/administration & dosage
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/*therapy
MH  - Netherlands
MH  - North Carolina
MH  - Platelet Glycoprotein GPIIb-IIIa Complex/*antagonists & inhibitors
MH  - Recurrence
MH  - Spain
MH  - Survival Analysis
MH  - Sweden
MH  - Tenecteplase
MH  - Tissue Plasminogen Activator/administration & dosage
MH  - Treatment Outcome
EDAT- 2003/10/03 05:00
MHDA- 2003/10/18 05:00
CRDT- 2003/10/03 05:00
PHST- 2003/10/03 05:00 [pubmed]
PHST- 2003/10/18 05:00 [medline]
PHST- 2003/10/03 05:00 [entrez]
AID - S0735109703009173 [pii]
AID - 10.1016/s0735-1097(03)00917-3 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2003 Oct 1;42(7):1178-85. doi: 10.1016/s0735-1097(03)00917-3.