Glycoprotein IIbIIIa Inhibitors Use and Outcome after Percutaneous Coronary Intervention for Non-ST Elevation Myocardial Infarction

الملخص EN

Aims.

We investigate the effect of glycoprotein IIb/IIIa (GP IIb/IIIa) inhibitors on long-term outcomes following percutaneous coronary intervention (PCI) after non-ST elevation myocardial infarction (NSTEMI).

Meta-analyses indicate that these agents are associated with improved short-term outcomes.

However, many trials were undertaken before the routine use of P2Y12 inhibitors.

Recent studies yield conflicting results and registry data have suggested that GP IIb/IIIa inhibitors may cause more bleeding than what trials indicate.

Methods and Results.

This retrospective observational study involves 3047 patients receiving dual-antiplatelet therapy who underwent PCI for NSTEMI.

Primary outcome was all-cause mortality.

Major adverse cardiac events (MACE) were a secondary outcome.

Mean follow-up was 4.6 years.

Patients treated with GP IIb/IIIa inhibitors were younger with fewer comorbidities.

Although the unadjusted Kaplan-Meier analysis suggested that GP IIb/IIIa inhibitor use was associated with improved outcomes, multivariate analysis (including propensity scoring) showed no benefit for either survival (P=0.136) or MACE (P=0.614).

GP IIb/IIIa inhibitor use was associated with an increased risk of major bleeding (P=0.021).

Conclusion.

Although GP IIb/IIIa inhibitor use appeared to improve outcomes after PCI for NSTEMI, patients who received GP IIb/IIIa inhibitors tended to be at lower risk.

After multivariate adjustment we observed no improvement in MACE or survival and an increased risk of major bleeding.