Abstract:
BACKGROUND:Studies have shown that cigarette smokers constitute a substantial proportion of patients with acute coronary syndromes (ACS) and have platelet-rich coronary thrombi. We characterized the influence of smoking status on outcome of patients with ACS without persistent ST-segment elevation and tested the hypothesis that selective inhibition of the platelet glycoprotein IIb/IIIa receptor with eptifibatide would improve outcomes among cigarette smokers. METHODS:The study population included patients enrolled in the PURSUIT trial (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) with known smoking status presenting with ischemic chest pain =24 hours and having either ischemic electrocardiographic changes without persistent ST-segment elevation or elevated creatine kinase MB levels. Patients were randomly assigned to receive a bolus and infusion of either eptifibatide or placebo in addition to standard therapy. The primary end point was a composite of death or nonfatal myocardial infarction within 30 days. RESULTS:Of the 9406 patients with known smoking status, 2677 were current smokers, 3086 were former smokers, and 3643 were nonsmokers. Cigarette smokers had better 30-day outcomes (12.3%, 16.8%, and 15.4% for smokers, former smokers, and nonsmokers, respectively; P =.001). However, after adjusting for differences in baseline clinical variables, smoking status was not a predictor of 30-day outcome (P =.45). There was a reduction in the composite end point overall with eptifibatide compared with placebo (14.3% vs 15. 7%, P =.054) but no interaction between smoking status and treatment strategy (P =.68). CONCLUSIONS:Among patients with ACS without persistent ST-segment elevation, cigarette smokers had better short-term outcomes because of their more favorable clinical profile. Although prior studies have suggested that smokers more commonly have platelet-rich thrombi than nonsmokers, eptifibatide did not result in more improvement in their outcome compared with former smokers or nonsmokers.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Hasdai D,Holmes DR Jr,Criger DA,Topol EJ,Califf RM,Wilcox RG,Paolasso E,Simoons M,Deckers J,Harrington RAdoi
10.1016/s0002-8703(00)90089-9subject
Has Abstractpub_date
2000-03-01 00:00:00pages
454-60issue
3eissn
0002-8703issn
1097-6744pii
S0002-8703(00)90089-9journal_volume
139pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Our goal was to evaluate cross-sectionally the association between ideal risk factor (IRF) profile and the presence and severity of subclinical atherosclerosis measured as coronary artery calcium (CAC) in the Brazilian Longitudinal Study of Adult Health. METHODS:We included 4,077 participants with no prior ...
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abstract::Oxygen free radical scavengers have been found to decrease infarct size in dogs subjected to myocardial ischemia-reperfusion injury. A baboon open-chest model was used to determine if superoxide dismutase (SOD), an oxygen free radical scavenger, together with catalase would be equally effective in subhuman primates (b...
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2006-06-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 信件
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pub_type: 杂志文章
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更新日期:2010-05-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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更新日期:2006-04-01 00:00:00