Feasibility and implications of an early discharge strategy after percutaneous intervention with abciximab in acute myocardial infarction (the CADILLAC Trial).
Publication/Presentation Date
10-1-2003
Abstract
Early complications may hamper efforts to hasten discharge after primary percutaneous coronary intervention (PCI) for myocardial infarction (MI). Glycoprotein IIb/IIIa inhibitors, by reducing early recurrent ischemia, may aid in these efforts. We examined whether adjunctive abciximab could accelerate discharge and reduce costs within a trial of primary PCI after acute MI. The CADILLAC trial randomized 2,082 patients with MI to 1 of 4 reperfusion strategies in a 2 x 2 factorial design: angioplasty, angioplasty with abciximab, stent implantation, or stenting with abciximab. Patients randomized to abciximab had postprocedural heparin withheld, and discharge scheduled for days 1.5 to 2 (low-risk patients) or days 2 to 3 (high-risk patients) after MI if they were stable. Other patients were discharged at the physician's discretion. Abciximab treatment was associated with significant reductions in the primary end points of in-hospital death, reinfarction, ischemic target vessel revascularization (TVR), or disabling stroke (5.6% vs 2.7%, p = 0.003)--largely reflecting reduced ischemic TVR (3.8% vs 1.4%, p = 0.002)--and in early subacute thrombosis (1.3% vs 0.2%, p = 0.01). Hospitalization was significantly shorter in abciximab-treated patients (median 3.1 vs 3.5 days, p
Volume
92
Issue
7
First Page
779
Last Page
784
ISSN
0002-9149
Published In/Presented At
Kandzari, D. E., Tcheng, J. E., Cohen, D. J., Bakhai, A., Grines, C. L., Cox, D. A., Effron, M., Stuckey, T., Griffin, J. J., Turco, M., Carroll, J. D., Fahy, M., Mehran, R., Stone, G. W., & CADILLAC Investigators (2003). Feasibility and implications of an early discharge strategy after percutaneous intervention with abciximab in acute myocardial infarction (the CADILLAC Trial). The American journal of cardiology, 92(7), 779–784. https://doi.org/10.1016/s0002-9149(03)00882-8
Disciplines
Medicine and Health Sciences
PubMedID
14516875
Department(s)
Department of Medicine
Document Type
Article