Navigation Links
Anticoagulant does not reduce rate of ischemic events among certain patients undergoing PCI
Date:9/1/2013

Use of the novel anticoagulant otamixaban did not reduce ischemic events compared with unfractionated heparin plus eptifibatide but increased bleeding among patients with nonST-segment elevation acute coronary syndromes undergoing a percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries), according to a study published by JAMA. The study is being released early online to coincide with its presentation at the European Society of Cardiology Congress 2013

"Major progress has been made in the management of nonST-segment elevation [a certain pattern on an electrocardiogram] acute coronary syndromes (NSTE-ACS) because of the availability of potent combinations of oral antiplatelet agents, injectable anticoagulants, and increasing use of an invasive strategy. Nevertheless, the risk of adverse outcomes remains substantial, and there is no consensus on a single optimal injectable anticoagulant that can be used across the continuum of care from the emergency setting through revascularization (when applicable)," according to background information in the article. The synthetic intravenous drug otamixaban inhibits thrombin [an enzyme that acts on fibrinogen in blood causing it to clot] generation in a dose-dependent manner. A phase 2 trial showed a reduction in the combined outcome of death or myocardial infarction (heart attack) in patients treated with otamixaban compared with unfractionated heparin (UFH) plus eptifibatide (an antiplatelet drug) and showed similar bleeding rates with otamixaban at midrange doses.

Philippe Gabriel Steg, M.D., of the Universit Paris-Diderot, Sorbonne-Paris Cit, Paris, and investigators with the TAO trial compared the clinical efficacy and safety of otamixaban with that of unfractionated heparin plus eptifibatide in 13,229 patients with NSTE-ACS and a planned early invasive strategy. The trial was conducted at 568 active sites in 55 countries between April 2010 and February 2013. Eligible participants were randomized to otamixaban or unfractionated heparin plus, at the time of PCI, eptifibatide.

The primary outcome of death or new myocardial infarction through day 7 occurred in 5.5 percent of the patients treated with otamixaban vs. 5.7 percent of the patients treated with UFH plus eptifibatide. Otamixaban did not significantly reduce the risk of any of the components of the primary outcomes, either death or heart attack, or of any of the secondary efficacy outcomes, including procedural thrombotic complications. Analysis of the primary outcome by 30 days confirmed the absence of a reduction with otamixaban.

In the lower-dose otamixaban group, discontinued by the data monitoring committee for futility based on the interim analysis, the rate of the primary outcome at day 7 was 6.3 percent.

Patients in the otamixaban group had about double the rate of the primary safety outcome of Thrombosis in Myocardial Infarction major or minor bleeding at day 7 compared with patients in the combination of UFH-plus-eptifibatide group (3.1 percent vs. 1.5 percent). Otamixaban consistently increased all types of bleeding events, regardless of the severity or bleeding classification scheme used. Study anticoagulant was discontinued because of bleeding in 242 patients (4.7 percent) in the otamixaban group and in 95 patients (1.7 percent) in the UFH-plus-eptifibatide group.

"Otamixaban did not reduce ischemic events compared with UFH plus eptifibatide but increased bleeding among patients with NSTE-ACS and a planned invasive strategy. These findings do not support the use of otamixaban for patients with NSTE-ACS undergoing planned early percutaneous coronary intervention," the authors conclude.


'/>"/>

Contact: Philippe Gabriel Steg, M.D.
gabriel.steg@bch.aphp.fr
The JAMA Network Journals
Source:Eurekalert

Related medicine news :

1. Huntingtons Disease Linked to Reduced Cancer Risk in Study
2. BMC study shows diverting passengers to elevators could help reduce falls at Logan Airport
3. Decision guide reduced uncertainty over breast cancer prevention, study finds
4. Scoliosis Treatment Might Reduce Need for Surgeries
5. Exercise helps smokers to quit smoking, to remain smoke-free and to reduce the risk of death
6. Additional blood pressure screening may reduce incidence of CVD events and death by up to 3 percent
7. Groundbreaking Nigeria summit results in major commitment to reduce child deaths
8. Soy-based S-equol supplement reduces hot flash frequency, muscle & joint pain in US women
9. Use of dedicated pediatric imaging departments for pediatric CT reduces radiation dose
10. Automated breast ultrasound dramatically reduces physician interpretation time
11. Diabetic retinopathy research could reduce screening costs
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2016)... , ... May 27, 2016 , ... W.S. Badger ... announced today that it has been recognized as one of the best small businesses ... was named as one of nine small businesses providing progressive benefits to new parents ...
(Date:5/27/2016)... NY (PRWEB) , ... May 27, 2016 , ... ... with Mediaplanet to help educate the many who are unaware of the plight ... to aphasia will run within the “Stroke Awareness” campaign. , The link between ...
(Date:5/27/2016)... ... May 27, 2016 , ... ... in the pharmaceutical, medical and food industries. Aside from its GMP accreditation, Validation ... providing proof of successfully certified products, services and staff. , Validation Center is ...
(Date:5/26/2016)... ... May 26, 2016 , ... Intalere, ... members and suppliers for its inaugural Member Conference at the Paris Hotel in ... elevating the operational health of America’s healthcare providers. , The conference was highlighted ...
(Date:5/26/2016)... ... May 26, 2016 , ... Cardiac arrhythmia ... negative impact on long-term patient survival, reports a team of UPMC researchers in ... week in the Journal of Thoracic and Cardiovascular Surgery, provide critical information that ...
Breaking Medicine News(10 mins):
(Date:5/25/2016)... May 25, 2016 According to ... Type (3D, 2D, 4D), by Therapeutic Area (Oncology, Cosmeceutical/Plastic ... User (Medical Device Manufacturers, Hospitals/ Clinics) - Forecast to ... Medical Animation Market for the forecast period of 2016 ... 301.3 Million by 2021 from USD 117.3 Million in ...
(Date:5/25/2016)... 25, 2016 According to market ... Growth and Demand Forecast to 2022 - Industry Insights ... Others)" published by P&S Market Research, the global insulin ... 2015, and it is expected to grow at a ... insulin pump segment is expected to witness the fastest ...
(Date:5/25/2016)... England , May 25, 2016 ... company employing the precision of circulating tumour DNA ... today announces the appointment of Professor Clive ... provide medical leadership across the clinical development programme, ... Inivata,s products help deliver significant improvements in clinical ...
Breaking Medicine Technology: