GP IIb/IIIa inhibitors improve outcome in patients with primary PCI for STEMI. Results of the prospective ALKK-Registry

Abstract

Background: There is still debate about the optimal antithrombotic therapy in patients undergoing primary PCI. Earlier randomized trials have shown a benefit of GP IIb/IIIa inhibitors, with the highest benefit in high risk patients. Most recent trials did not support the earlier data. Therefore we evaluated the impact of GP IIb/IIIa inhibitors on outcome in patients with primary PCI for STEMI in real life in a large number of patients. Methods: We used the data of the ongoing prospective ALKK-PCI registry and included patients with PCI for STEMI < 24 h duration before PCI. Results: Between 2005 and 2011 a total of 21977 consecutive patients with PCI for STEMI without cardiogenic shock were included. Of these 12650 (57.6%) received a GP IIb/IIIa inhibitor. Baseline characteristics, procedural features and in-hospital outcomes are given in the table. In a multivariate analysis GP IIb/IIIa inhibitors were associated with a reduced mortality (odds ratio 0.73, 95% CI 0.62-0.87). View this table: Conclusion: In clinical practice GP IIb/IIIa inhibitors are used in more than 50% of the patients with primary PCI for STEMI. The use is associated with an improved mortality without an increase in bleeding complications. This data support the results of randomized clinical trials.