Outcomes at 1 year and economic implications of platelet glycoprotein IIb/IIIa blockade in patients undergoing coronary stenting: results from a multicentre randomised trial

Topol, Eric J.; Mark, Daniel B.; Lincoff, A. Michael; Cohen, Éric A.; Burton, Jeffrey R.; Kleiman, Neal S.; Talley, David; Sapp, Shelly; Booth, John V.; Cabot, Catherine F.; Anderson, Keaven M.; Califf, Robert M.

doi:10.1016/s0140-6736(99)10018-7

Cited by 301 publications

(162 citation statements)

References 30 publications

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“…Our audit data indicate that 78% of these procedures (22,958) were elective and 88% of these elective procedures (20,203) were for either single-or two-vessel disease.…”

Section: Cost Increases Associated With Desmentioning

confidence: 90%

“…17,18 Use of ticlopidine has been stopped owing to adverse reactions and the use of clopidogrel has become common, although the length of time for continued treatment continues to be debated. 19 The clinical and cost-effectiveness of these treatments are now being reported 20 and a review of the effectiveness of clopidogrel is currently being carried out in the UK.…”

Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

See 1 more Smart Citation

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

144

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“…Our audit data indicate that 78% of these procedures (22,958) were elective and 88% of these elective procedures (20,203) were for either single-or two-vessel disease.…”

Section: Cost Increases Associated With Desmentioning

confidence: 90%

Section: Adjunctive Pharmacotherapymentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

144

View full text Add to dashboard Cite

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“…20 Moreover, this agent has been associated with a long-term decrease in mortality, an effect that cannot be entirely attributed to the suppression of acute periprocedural ischemic events. 21 Mortality reduction has not been observed to date with eptifibatide or tirofiban. Apparent heterogeneity in the magnitude of treatment effect observed in these trials between the antibody fragment and the reversible small molecule inhibitors may reflect differences in the intensity and duration of receptor blockade, inadequate dosing, variations in trial design, or statistical chance.…”

Section: Lincoff Et Al Abciximab and Markers Of Inflammation 165mentioning

confidence: 99%

Abciximab Suppresses the Rise in Levels of Circulating Inflammatory Markers After Percutaneous Coronary Revascularization

Lincoff¹,

Kereiakes

Mascelli³

et al. 2001

Circulation

190

107

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Background-Previous investigators have shown that systemic markers of inflammation may be increased in patients withacute ischemic syndromes or after percutaneous coronary revascularization and that persistent elevation in these markers is predictive of excess risk of subsequent adverse cardiac events. By virtue of its cross-reactivity with the glycoprotein IIb/IIIa, av␤3, and ␣M␤2 receptors, abciximab may reduce inflammatory processes. Methods and Results-Assays for the inflammatory markers C-reactive protein, interleukin-6, and tumor necrosis factor-␣ were performed on serum samples obtained from 160 patients in a placebo-controlled, randomized trial of abciximab during angioplasty. Eighty patients each had received a placebo or abciximab bolus plus a 12-hour infusion. Serum samples were drawn at baseline (before revascularization), 24 to 48 hours after study drug administration, and 4 weeks after study drug administration. Between baseline and 24 to 48 hours, the increase in C-reactive protein was 32% less in patients receiving abciximab than placebo (Pϭ0.025); the rise in interleukin-6 levels was 76% less in the abciximab group (PϽ0.001); and the rise in tumor necrosis factor-␣ levels was 100% less with abciximab therapy (Pϭ0.112). By 4 weeks, most marker levels had returned to baseline, with no significant differences between placebo and abciximab groups. Conclusions-Systemic markers of inflammation increase in the first 24 to 48 hours after angioplasty, but the magnitude of that rise is diminished by periprocedural abciximab. Some of the long-term clinical benefit derived from this agent may be related to an anti-inflammatory effect.

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“…17 In the recently completed Evaluation of IIb/IIIa Platelet Inhibitor for STENTing (EPISTENT) trial, the average hospital cost plus professional fees for 1 year of stent strategy alone was Ϸ$17 000; for balloon angioplasty plus abciximab it was $17 400, and stent plus abciximab was Ϸ$18 000. 18 Projecting the 1-year outcomes to a lifetime perspective, the stent plus abciximab group had an incremental life expectancy (compared with the balloon angioplasty plus abciximab arm) of 0.11 years and an incremental cost-effectiveness ratio of $5300 per added life-year. Compared with the stent alone arm, the stent plus abciximab group had an incremental life expectancy of 0.15 years and an incremental cost-effectiveness ratio of $6200 per added life-year.…”

Section: Recent Developments In Pcimentioning

confidence: 99%