Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial
Background Thrombus burden and distal embolization are predictive of no-reflow during primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). We sought to compare the efficacy of pharmacological and catheter-based strategies for thrombus in...
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| Veröffentlicht in: | The American heart journal 2015-12, Vol.170 (6), p.1116-1123 |
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| creator | Prati, Francesco, MD Romagnoli, Enrico, MD, PHD Limbruno, Ugo, MD Pawlowski, Tomasz, MD Fedele, Silvio, MD Gatto, Laura, MD Di Vito, Luca, MD Pappalardo, Alessandro, MD Ramazzotti, Vito, MD Picchi, Andrea, MD Trivisonno, Antonio, MD Materia, Laura, RN Pfiatkosky, Piotre, MD Paoletti, Giulia, MD Marco, Valeria, RN Tavazzi, Luigi, MD Versaci, Francesco, MD Stone, Gregg W., MD, PHD |
| description | Background Thrombus burden and distal embolization are predictive of no-reflow during primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). We sought to compare the efficacy of pharmacological and catheter-based strategies for thrombus in patients with STEMI and high atherothrombotic burden. Methods Between January 2012 and December 2013, 128 STEMI patients undergoing primary PCI at 5 centers were randomly assigned in a 2 × 2 factorial design to intracoronary (IC) abciximab bolus (via the guide catheter) versus intralesion (IL) abciximab bolus, each with versus without aspiration thrombectomy (AT). Study end points were residual intrastent atherothrombotic burden, defined as the number of cross-sections with residual tissue area >10% as assessed by optical coherence tomography, and indices of angiographic and myocardial reperfusion. Results Residual intrastent atherothrombotic burden did not significantly differ with IL versus IC abciximab (median [interquartile range] 6.0 [1-15] vs 6.0 [2-11], P = .806) and with AT versus no aspiration (6.0 [1-13] vs 6.0 [2-12], P = .775). Intralesion abciximab administration was associated with improved angiographic myocardial reperfusion in terms of thrombolysis in myocardial infarction (TIMI) flow (3 [3-3] vs 3 [2-3], P = .040), corrected TIMI frame count (12 ± 5 vs 17 ± 16, P = .021), and myocardial blush grade (3 [2-3] vs 3 [2-3], P = .035). In particular, IL abciximab was associated with higher occurrence of final TIMI 3 flow (90% vs 73.8%, P = .032) and myocardial blush grade 3 (71.6% vs 52.4%, P = .039). Conversely, AT had no significant effect on indices of angiographic or myocardial reperfusion. Conclusions In patients with STEMI and high thrombotic burden, neither IL versus IC abciximab nor AT versus no aspiration reduced postprocedure intrastent atherothrombotic burden in patients with STEMI undergoing primary PCI. However, IL abciximab improved indices of angiographic and myocardial reperfusion compared to IC abciximab, benefits not apparent with AT. |
| doi_str_mv | 10.1016/j.ahj.2015.08.020 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1750429907</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870315005773</els_id><sourcerecordid>3911671251</sourcerecordid><originalsourceid>FETCH-LOGICAL-c436t-d4eca9d84e9b17424e7750ee91033bd748622337b89fd2b892b485d28b2860323</originalsourceid><addsrcrecordid>eNp9kl2L1DAYhYso7rj6A7yRgDfetOarTauwsAx-DAwsuON1SJO3TGrbjEk7Wv-R_9LUrgp74U1CXp5z0p6TJHlOcEYwKV63mTq2GcUkz3CZYYofJBuCK5EWgvOHyQZjTNNSYHaRPAmhjceClsXj5IIWhSgLxjbJz09qMK63P8AgOKtuUqN1A3INssPoVQdhOZ7BhymsI-28G5Sfkaq1_W57VaNogVQ4Wb-Kx6N3fQ16dP0cNegUxzCMAX2z4xHdHlLo4lW_0X52WnljVRfBRnm9TN-gwxHQ9mZ7uN7t0W6HRh-Bp8mjRnUBnt3tl8nn9-8O24_p_ubDbnu9TzVnxZgaDlpVpuRQ1URwykGIHANUBDNWG8HLglLGRF1WjaFxpTUvc0PLOkaDGWWXyavV9-Td1wnCKHsbNHSdGsBNQZJox2lVYRHRl_fQ1k1-iF-3UIxywcViSFZKexeCh0aefIzNz5JgufQoWxl7lEuPEpcy9hg1L-6cp7oH81fxp7gIvF0BiFGcLXgZdAxZg7E-Ji-Ns_-1v7qn1p0drFbdF5gh_PsLGajE8nZ5SMs7IjnGuRCM_QKgwMSY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1753247472</pqid></control><display><type>article</type><title>Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Prati, Francesco, MD ; Romagnoli, Enrico, MD, PHD ; Limbruno, Ugo, MD ; Pawlowski, Tomasz, MD ; Fedele, Silvio, MD ; Gatto, Laura, MD ; Di Vito, Luca, MD ; Pappalardo, Alessandro, MD ; Ramazzotti, Vito, MD ; Picchi, Andrea, MD ; Trivisonno, Antonio, MD ; Materia, Laura, RN ; Pfiatkosky, Piotre, MD ; Paoletti, Giulia, MD ; Marco, Valeria, RN ; Tavazzi, Luigi, MD ; Versaci, Francesco, MD ; Stone, Gregg W., MD, PHD</creator><creatorcontrib>Prati, Francesco, MD ; Romagnoli, Enrico, MD, PHD ; Limbruno, Ugo, MD ; Pawlowski, Tomasz, MD ; Fedele, Silvio, MD ; Gatto, Laura, MD ; Di Vito, Luca, MD ; Pappalardo, Alessandro, MD ; Ramazzotti, Vito, MD ; Picchi, Andrea, MD ; Trivisonno, Antonio, MD ; Materia, Laura, RN ; Pfiatkosky, Piotre, MD ; Paoletti, Giulia, MD ; Marco, Valeria, RN ; Tavazzi, Luigi, MD ; Versaci, Francesco, MD ; Stone, Gregg W., MD, PHD</creatorcontrib><description>Background Thrombus burden and distal embolization are predictive of no-reflow during primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). We sought to compare the efficacy of pharmacological and catheter-based strategies for thrombus in patients with STEMI and high atherothrombotic burden. Methods Between January 2012 and December 2013, 128 STEMI patients undergoing primary PCI at 5 centers were randomly assigned in a 2 × 2 factorial design to intracoronary (IC) abciximab bolus (via the guide catheter) versus intralesion (IL) abciximab bolus, each with versus without aspiration thrombectomy (AT). Study end points were residual intrastent atherothrombotic burden, defined as the number of cross-sections with residual tissue area >10% as assessed by optical coherence tomography, and indices of angiographic and myocardial reperfusion. Results Residual intrastent atherothrombotic burden did not significantly differ with IL versus IC abciximab (median [interquartile range] 6.0 [1-15] vs 6.0 [2-11], P = .806) and with AT versus no aspiration (6.0 [1-13] vs 6.0 [2-12], P = .775). Intralesion abciximab administration was associated with improved angiographic myocardial reperfusion in terms of thrombolysis in myocardial infarction (TIMI) flow (3 [3-3] vs 3 [2-3], P = .040), corrected TIMI frame count (12 ± 5 vs 17 ± 16, P = .021), and myocardial blush grade (3 [2-3] vs 3 [2-3], P = .035). In particular, IL abciximab was associated with higher occurrence of final TIMI 3 flow (90% vs 73.8%, P = .032) and myocardial blush grade 3 (71.6% vs 52.4%, P = .039). Conversely, AT had no significant effect on indices of angiographic or myocardial reperfusion. Conclusions In patients with STEMI and high thrombotic burden, neither IL versus IC abciximab nor AT versus no aspiration reduced postprocedure intrastent atherothrombotic burden in patients with STEMI undergoing primary PCI. However, IL abciximab improved indices of angiographic and myocardial reperfusion compared to IC abciximab, benefits not apparent with AT.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2015.08.020</identifier><identifier>PMID: 26678633</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Angioplasty ; Antibodies, Monoclonal - administration & dosage ; Antibodies, Monoclonal - adverse effects ; Blood clots ; Cardiovascular ; Catheters ; Coronary Angiography - methods ; Coronary Restenosis - diagnosis ; Coronary Restenosis - etiology ; Coronary Restenosis - therapy ; Female ; Heart attacks ; Humans ; Immunoglobulin Fab Fragments - administration & dosage ; Immunoglobulin Fab Fragments - adverse effects ; Male ; Middle Aged ; Myocardial Infarction - complications ; Myocardial Infarction - diagnosis ; Myocardial Reperfusion - methods ; No-Reflow Phenomenon - diagnosis ; No-Reflow Phenomenon - etiology ; No-Reflow Phenomenon - therapy ; Percutaneous Coronary Intervention - adverse effects ; Percutaneous Coronary Intervention - methods ; Platelet Aggregation Inhibitors ; Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors ; Postoperative Complications - diagnosis ; Postoperative Complications - therapy ; Thrombectomy - adverse effects ; Thrombectomy - methods ; Thrombosis - diagnosis ; Thrombosis - etiology ; Thrombosis - therapy ; Tomography ; Tomography, Optical Coherence - methods ; Treatment Outcome</subject><ispartof>The American heart journal, 2015-12, Vol.170 (6), p.1116-1123</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Dec 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c436t-d4eca9d84e9b17424e7750ee91033bd748622337b89fd2b892b485d28b2860323</citedby><cites>FETCH-LOGICAL-c436t-d4eca9d84e9b17424e7750ee91033bd748622337b89fd2b892b485d28b2860323</cites><orcidid>0000-0003-4799-9459 ; 0000-0003-0312-2030</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870315005773$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26678633$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Prati, Francesco, MD</creatorcontrib><creatorcontrib>Romagnoli, Enrico, MD, PHD</creatorcontrib><creatorcontrib>Limbruno, Ugo, MD</creatorcontrib><creatorcontrib>Pawlowski, Tomasz, MD</creatorcontrib><creatorcontrib>Fedele, Silvio, MD</creatorcontrib><creatorcontrib>Gatto, Laura, MD</creatorcontrib><creatorcontrib>Di Vito, Luca, MD</creatorcontrib><creatorcontrib>Pappalardo, Alessandro, MD</creatorcontrib><creatorcontrib>Ramazzotti, Vito, MD</creatorcontrib><creatorcontrib>Picchi, Andrea, MD</creatorcontrib><creatorcontrib>Trivisonno, Antonio, MD</creatorcontrib><creatorcontrib>Materia, Laura, RN</creatorcontrib><creatorcontrib>Pfiatkosky, Piotre, MD</creatorcontrib><creatorcontrib>Paoletti, Giulia, MD</creatorcontrib><creatorcontrib>Marco, Valeria, RN</creatorcontrib><creatorcontrib>Tavazzi, Luigi, MD</creatorcontrib><creatorcontrib>Versaci, Francesco, MD</creatorcontrib><creatorcontrib>Stone, Gregg W., MD, PHD</creatorcontrib><title>Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Thrombus burden and distal embolization are predictive of no-reflow during primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). We sought to compare the efficacy of pharmacological and catheter-based strategies for thrombus in patients with STEMI and high atherothrombotic burden. Methods Between January 2012 and December 2013, 128 STEMI patients undergoing primary PCI at 5 centers were randomly assigned in a 2 × 2 factorial design to intracoronary (IC) abciximab bolus (via the guide catheter) versus intralesion (IL) abciximab bolus, each with versus without aspiration thrombectomy (AT). Study end points were residual intrastent atherothrombotic burden, defined as the number of cross-sections with residual tissue area >10% as assessed by optical coherence tomography, and indices of angiographic and myocardial reperfusion. Results Residual intrastent atherothrombotic burden did not significantly differ with IL versus IC abciximab (median [interquartile range] 6.0 [1-15] vs 6.0 [2-11], P = .806) and with AT versus no aspiration (6.0 [1-13] vs 6.0 [2-12], P = .775). Intralesion abciximab administration was associated with improved angiographic myocardial reperfusion in terms of thrombolysis in myocardial infarction (TIMI) flow (3 [3-3] vs 3 [2-3], P = .040), corrected TIMI frame count (12 ± 5 vs 17 ± 16, P = .021), and myocardial blush grade (3 [2-3] vs 3 [2-3], P = .035). In particular, IL abciximab was associated with higher occurrence of final TIMI 3 flow (90% vs 73.8%, P = .032) and myocardial blush grade 3 (71.6% vs 52.4%, P = .039). Conversely, AT had no significant effect on indices of angiographic or myocardial reperfusion. Conclusions In patients with STEMI and high thrombotic burden, neither IL versus IC abciximab nor AT versus no aspiration reduced postprocedure intrastent atherothrombotic burden in patients with STEMI undergoing primary PCI. However, IL abciximab improved indices of angiographic and myocardial reperfusion compared to IC abciximab, benefits not apparent with AT.</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Antibodies, Monoclonal - administration & dosage</subject><subject>Antibodies, Monoclonal - adverse effects</subject><subject>Blood clots</subject><subject>Cardiovascular</subject><subject>Catheters</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Restenosis - diagnosis</subject><subject>Coronary Restenosis - etiology</subject><subject>Coronary Restenosis - therapy</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Immunoglobulin Fab Fragments - administration & dosage</subject><subject>Immunoglobulin Fab Fragments - adverse effects</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - complications</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Reperfusion - methods</subject><subject>No-Reflow Phenomenon - diagnosis</subject><subject>No-Reflow Phenomenon - etiology</subject><subject>No-Reflow Phenomenon - therapy</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Platelet Aggregation Inhibitors</subject><subject>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</subject><subject>Postoperative Complications - diagnosis</subject><subject>Postoperative Complications - therapy</subject><subject>Thrombectomy - adverse effects</subject><subject>Thrombectomy - methods</subject><subject>Thrombosis - diagnosis</subject><subject>Thrombosis - etiology</subject><subject>Thrombosis - therapy</subject><subject>Tomography</subject><subject>Tomography, Optical Coherence - methods</subject><subject>Treatment Outcome</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kl2L1DAYhYso7rj6A7yRgDfetOarTauwsAx-DAwsuON1SJO3TGrbjEk7Wv-R_9LUrgp74U1CXp5z0p6TJHlOcEYwKV63mTq2GcUkz3CZYYofJBuCK5EWgvOHyQZjTNNSYHaRPAmhjceClsXj5IIWhSgLxjbJz09qMK63P8AgOKtuUqN1A3INssPoVQdhOZ7BhymsI-28G5Sfkaq1_W57VaNogVQ4Wb-Kx6N3fQ16dP0cNegUxzCMAX2z4xHdHlLo4lW_0X52WnljVRfBRnm9TN-gwxHQ9mZ7uN7t0W6HRh-Bp8mjRnUBnt3tl8nn9-8O24_p_ubDbnu9TzVnxZgaDlpVpuRQ1URwykGIHANUBDNWG8HLglLGRF1WjaFxpTUvc0PLOkaDGWWXyavV9-Td1wnCKHsbNHSdGsBNQZJox2lVYRHRl_fQ1k1-iF-3UIxywcViSFZKexeCh0aefIzNz5JgufQoWxl7lEuPEpcy9hg1L-6cp7oH81fxp7gIvF0BiFGcLXgZdAxZg7E-Ji-Ns_-1v7qn1p0drFbdF5gh_PsLGajE8nZ5SMs7IjnGuRCM_QKgwMSY</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Prati, Francesco, MD</creator><creator>Romagnoli, Enrico, MD, PHD</creator><creator>Limbruno, Ugo, MD</creator><creator>Pawlowski, Tomasz, MD</creator><creator>Fedele, Silvio, MD</creator><creator>Gatto, Laura, MD</creator><creator>Di Vito, Luca, MD</creator><creator>Pappalardo, Alessandro, MD</creator><creator>Ramazzotti, Vito, MD</creator><creator>Picchi, Andrea, MD</creator><creator>Trivisonno, Antonio, MD</creator><creator>Materia, Laura, RN</creator><creator>Pfiatkosky, Piotre, MD</creator><creator>Paoletti, Giulia, MD</creator><creator>Marco, Valeria, RN</creator><creator>Tavazzi, Luigi, MD</creator><creator>Versaci, Francesco, MD</creator><creator>Stone, Gregg W., MD, PHD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4799-9459</orcidid><orcidid>https://orcid.org/0000-0003-0312-2030</orcidid></search><sort><creationdate>20151201</creationdate><title>Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial</title><author>Prati, Francesco, MD ; Romagnoli, Enrico, MD, PHD ; Limbruno, Ugo, MD ; Pawlowski, Tomasz, MD ; Fedele, Silvio, MD ; Gatto, Laura, MD ; Di Vito, Luca, MD ; Pappalardo, Alessandro, MD ; Ramazzotti, Vito, MD ; Picchi, Andrea, MD ; Trivisonno, Antonio, MD ; Materia, Laura, RN ; Pfiatkosky, Piotre, MD ; Paoletti, Giulia, MD ; Marco, Valeria, RN ; Tavazzi, Luigi, MD ; Versaci, Francesco, MD ; Stone, Gregg W., MD, PHD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c436t-d4eca9d84e9b17424e7750ee91033bd748622337b89fd2b892b485d28b2860323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Antibodies, Monoclonal - administration & dosage</topic><topic>Antibodies, Monoclonal - adverse effects</topic><topic>Blood clots</topic><topic>Cardiovascular</topic><topic>Catheters</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Restenosis - diagnosis</topic><topic>Coronary Restenosis - etiology</topic><topic>Coronary Restenosis - therapy</topic><topic>Female</topic><topic>Heart attacks</topic><topic>Humans</topic><topic>Immunoglobulin Fab Fragments - administration & dosage</topic><topic>Immunoglobulin Fab Fragments - adverse effects</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - complications</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Reperfusion - methods</topic><topic>No-Reflow Phenomenon - diagnosis</topic><topic>No-Reflow Phenomenon - etiology</topic><topic>No-Reflow Phenomenon - therapy</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Platelet Aggregation Inhibitors</topic><topic>Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors</topic><topic>Postoperative Complications - diagnosis</topic><topic>Postoperative Complications - therapy</topic><topic>Thrombectomy - adverse effects</topic><topic>Thrombectomy - methods</topic><topic>Thrombosis - diagnosis</topic><topic>Thrombosis - etiology</topic><topic>Thrombosis - therapy</topic><topic>Tomography</topic><topic>Tomography, Optical Coherence - methods</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Prati, Francesco, MD</creatorcontrib><creatorcontrib>Romagnoli, Enrico, MD, PHD</creatorcontrib><creatorcontrib>Limbruno, Ugo, MD</creatorcontrib><creatorcontrib>Pawlowski, Tomasz, MD</creatorcontrib><creatorcontrib>Fedele, Silvio, MD</creatorcontrib><creatorcontrib>Gatto, Laura, MD</creatorcontrib><creatorcontrib>Di Vito, Luca, MD</creatorcontrib><creatorcontrib>Pappalardo, Alessandro, MD</creatorcontrib><creatorcontrib>Ramazzotti, Vito, MD</creatorcontrib><creatorcontrib>Picchi, Andrea, MD</creatorcontrib><creatorcontrib>Trivisonno, Antonio, MD</creatorcontrib><creatorcontrib>Materia, Laura, RN</creatorcontrib><creatorcontrib>Pfiatkosky, Piotre, MD</creatorcontrib><creatorcontrib>Paoletti, Giulia, MD</creatorcontrib><creatorcontrib>Marco, Valeria, RN</creatorcontrib><creatorcontrib>Tavazzi, Luigi, MD</creatorcontrib><creatorcontrib>Versaci, Francesco, MD</creatorcontrib><creatorcontrib>Stone, Gregg W., MD, PHD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Prati, Francesco, MD</au><au>Romagnoli, Enrico, MD, PHD</au><au>Limbruno, Ugo, MD</au><au>Pawlowski, Tomasz, MD</au><au>Fedele, Silvio, MD</au><au>Gatto, Laura, MD</au><au>Di Vito, Luca, MD</au><au>Pappalardo, Alessandro, MD</au><au>Ramazzotti, Vito, MD</au><au>Picchi, Andrea, MD</au><au>Trivisonno, Antonio, MD</au><au>Materia, Laura, RN</au><au>Pfiatkosky, Piotre, MD</au><au>Paoletti, Giulia, MD</au><au>Marco, Valeria, RN</au><au>Tavazzi, Luigi, MD</au><au>Versaci, Francesco, MD</au><au>Stone, Gregg W., MD, PHD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>170</volume><issue>6</issue><spage>1116</spage><epage>1123</epage><pages>1116-1123</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Thrombus burden and distal embolization are predictive of no-reflow during primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation myocardial infarction (STEMI). We sought to compare the efficacy of pharmacological and catheter-based strategies for thrombus in patients with STEMI and high atherothrombotic burden. Methods Between January 2012 and December 2013, 128 STEMI patients undergoing primary PCI at 5 centers were randomly assigned in a 2 × 2 factorial design to intracoronary (IC) abciximab bolus (via the guide catheter) versus intralesion (IL) abciximab bolus, each with versus without aspiration thrombectomy (AT). Study end points were residual intrastent atherothrombotic burden, defined as the number of cross-sections with residual tissue area >10% as assessed by optical coherence tomography, and indices of angiographic and myocardial reperfusion. Results Residual intrastent atherothrombotic burden did not significantly differ with IL versus IC abciximab (median [interquartile range] 6.0 [1-15] vs 6.0 [2-11], P = .806) and with AT versus no aspiration (6.0 [1-13] vs 6.0 [2-12], P = .775). Intralesion abciximab administration was associated with improved angiographic myocardial reperfusion in terms of thrombolysis in myocardial infarction (TIMI) flow (3 [3-3] vs 3 [2-3], P = .040), corrected TIMI frame count (12 ± 5 vs 17 ± 16, P = .021), and myocardial blush grade (3 [2-3] vs 3 [2-3], P = .035). In particular, IL abciximab was associated with higher occurrence of final TIMI 3 flow (90% vs 73.8%, P = .032) and myocardial blush grade 3 (71.6% vs 52.4%, P = .039). Conversely, AT had no significant effect on indices of angiographic or myocardial reperfusion. Conclusions In patients with STEMI and high thrombotic burden, neither IL versus IC abciximab nor AT versus no aspiration reduced postprocedure intrastent atherothrombotic burden in patients with STEMI undergoing primary PCI. However, IL abciximab improved indices of angiographic and myocardial reperfusion compared to IC abciximab, benefits not apparent with AT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26678633</pmid><doi>10.1016/j.ahj.2015.08.020</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4799-9459</orcidid><orcidid>https://orcid.org/0000-0003-0312-2030</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-8703 |
| ispartof | The American heart journal, 2015-12, Vol.170 (6), p.1116-1123 |
| issn | 0002-8703 1097-6744 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1750429907 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Aged Angioplasty Antibodies, Monoclonal - administration & dosage Antibodies, Monoclonal - adverse effects Blood clots Cardiovascular Catheters Coronary Angiography - methods Coronary Restenosis - diagnosis Coronary Restenosis - etiology Coronary Restenosis - therapy Female Heart attacks Humans Immunoglobulin Fab Fragments - administration & dosage Immunoglobulin Fab Fragments - adverse effects Male Middle Aged Myocardial Infarction - complications Myocardial Infarction - diagnosis Myocardial Reperfusion - methods No-Reflow Phenomenon - diagnosis No-Reflow Phenomenon - etiology No-Reflow Phenomenon - therapy Percutaneous Coronary Intervention - adverse effects Percutaneous Coronary Intervention - methods Platelet Aggregation Inhibitors Platelet Glycoprotein GPIIb-IIIa Complex - antagonists & inhibitors Postoperative Complications - diagnosis Postoperative Complications - therapy Thrombectomy - adverse effects Thrombectomy - methods Thrombosis - diagnosis Thrombosis - etiology Thrombosis - therapy Tomography Tomography, Optical Coherence - methods Treatment Outcome |
| title | Randomized evaluation of intralesion versus intracoronary abciximab and aspiration thrombectomy in patients with ST-elevation myocardial infarction: The COCTAIL II trial |
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