Outcomes of patients with acute coronary syndromes and prior coronary artery bypass grafting - Results from the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial

Article

关键词: SAPHENOUS-VEIN GRAFTS;    ACUTE MYOCARDIAL-INFARCTION;    FOLLOW-UP;    INTERNATIONAL TRIAL;    STENT IMPLANTATION;    SURGERY;    SURVIVAL;    PREDICTORS;    INTERVENTION;    THROMBOLYSIS;   

DOI  :  10.1161/hc0302.102578

来源: SCIE

【 摘 要 】

Background-Patients with prior CABG with a subsequent non-ST-segment elevation acute coronary syndrome (ACS) pose an increasingly important clinical problem. Although GP IIb/IIIa inhibitors have improved the outcome of patients with ACS, their efficacy in patients with prior CABG has not been previously evaluated. Methods and Results-We analyzed the 30- and 180-day outcomes of patients with prior CABG enrolled in the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial. In this trial, which evaluated the efficacy of eptifibatide in patients with ACS. 1134 patient's (12%) with prior CABG and 8321 without prior CABG were enrolled. After adjusting for differences in baseline characteristics and treatment, patients with prior CABG had a significantly higher mortality rates at 30 days (hazard ratio [HR]. 1.45 [95% (CI, 1.06 to 1.98]; P=0.019) and at 180 days (HR, 1.32 [95% CI, 1.04 to 1.67], P=0.021). At 30 days, there was a similar effect on the primary end point of death or myocardial infarction in the eptifibatide group versus the placebo group in prior CABG patients (unadjusted HR, 0.90 [95% Cl, 0.67 to 1.20]) and in patients without a history of CABG (unadjusted HR, 0,89 [95% CI, 0.80 to 0.99]). Conclusions-Patients with prior CABG with non-ST-segment elevation ACS have a significantly worse prognosis than do patients without a history of CABG. The treatment effect of eptifibatide in the prior CABG group was Similar to the effect seen in patients without prior CABG.

【 授权许可】

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