[Glycoprotein IIb/IIIa platelet blockers in acute XXXX treated with primary coronary angioplasty].

@entity1 @entity101 @entity117 @entity1188 @entity453 @entity583 @entity715
BACKGROUND: Primary coronary angioplasty is at present accepted as the most effective reperfusion treatment strategy of the ST elevation acute @entity583 . The optimum approach appears to be combination of the interventional technique (mechanical reperfusion) with aggressive pharmacological treatment aimed at the platelets. Intravenous blockers of the glycoprotein receptors IIb/IIIa together with @entity117 have the additive antiaggregant effect and are used more frequently as adjunctive therapy by coronary interventions in @entity1 with @entity583 . AIM: The assessment of safety and effectiveness of the IIb/IIIa platelet blockers in @entity1 indicated to primary coronary angioplasty. METHODS: Since 1st January 2000 to 30th June 2001 the authors carried out the total of 912 coronary angioplasties in their cathlab, from which in 195 cases (21.4%) the primary angioplasty in @entity583 was conducted. IIb/IIIa blockers were administered in the total of 53 cases (5.1% from the whole amount of coronary angioplasties), in 30 cases (15.4% from the total of 195 @entity1 ) of the primary coronary angioplasties, unlike the elective procedures, where these agents were given only in 9 @entity1 (1.5% from the overall number of 621 coronary angioplasties) (p < 0.001). The authors in their work analyse the group of @entity1 treated with primary coronary angioplasty with adjuvant treatment of IIb/IIIa platelet blockers. RESULTS: In the stated period the IIb/IIIa platelet blockers were given to 30 @entity1 at the age of 60.3 +/- 11.3 on average (70% were @entity1 ). The most frequent risk factors were smoking, in 18 @entity1 (60%), and @entity101 , in 14 @entity1 (40%). At least one coronary stent was implanted in 20 @entity1 (66.7%). Abciximab was administered in 27 cases (90%) and eptifibatid in 5 cases (10%). Solely in 5 cases (16.7%) the agents were administered at least 10 minutes before the intervention and therefore preventively, and in 25 cases (83.3%) the administration was rescue. The reason for preventive administration was in 3 cases determination of the angiographically high-risk @entity453 and in 2 cases the @entity715 of another non-infarction related artery. The most frequent reason for the rescue use was in 6 cases (22.2%) slow-flow or no-reflow fenomena even after the mechanical obstacles and in 5 cases (18.5%) that were successfully treated with further dilatation, the acute in-stent @entity715 was observed. The @entity1188 was most often the left anterior descending coronary artery, namely in 16 cases (54%). CONCLUSION: IIb/IIIa platelet blockers in primary coronary angioplasty administered either preventively or as rescue therapy are highly effective, relatively safe and improve the effectiveness of mechanical reperfusion. The total in-hospital mortality of this group of @entity1 was 10%.
