RT Journal Article
SR Electronic
T1 9 Routine use of glycoprotein IIB/IIIA inhibitors is associated with improved survival in primary PCI
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP A4
OP A5
DO 10.1136/heartjnl-2017-BCIS.9
VO 103
IS Suppl 7
A1 M Orzalkiewicz
A1 J Hodson
A1 P Ludman
A1 S George
A1 SN Doshi
A1 S Khan
A1 M Mamas
A1 D Hildick-Smith
A1 JN Townend
A1 PA Calvert
YR 2017
UL http://heart.bmj.com/content/103/Suppl_7/A4.2.abstract
AB Background The role of glycoprotein IIb/IIIa inhibitors (GPI) in primary PCI (PPCI) remains uncertain. We aim to compare patient outcomes between routine and selective GPI usage strategies.Methods All consecutive PPCIs in England between January 2009 and April 2015 were prospectively recorded in the BCIS database. The cohort was divided into routine and selective GPI usage groups based on the responsible consultant’s (RC) strategy. The primary endpoint was all-cause mortality, which was compared using Cox regression analyses.Results We assessed 110327 PPCIs. Routine compared to selective GPI usage (defined as GPI used in ≥75% and≤25% PPCIs performed by RC, respectively) was associated with significantly decreased Kaplan-Meier estimated rates for all-cause mortality at one year of 9.7% vs 11.0% (p<0.001) (figure 1). After multivariable adjustment, routine use of GPI was associated with less mortality (hazard ratio [HR]=0.87, 95%confidence interval [0.82–0.91], p<0.001) and repeat PCI for acute coronary syndrome (HR=0.82 [0.76–0.88], p<0.001) during the median follow-up of 18 months (IQR 1.2–32.4). Subgroup analysis found the survival benefit of routine GPI use to be similar for different P2Y12 inhibitors (p=0.339).Conclusion A strategy of routine GPI usage in patients undergoing PPCI was associated with lower all-cause mortality as compared to selective GPI usage.Abstract 9 Figure 1