Inpharma 1655 - 13 Sep 2008

Immediate angioplasty for MIcontinues to impress in CARESSPrevious 30-day results from the CARESS in AMI*

study showed that immediate transfer for angioplastywas superior to standard care for patients with acutemyocardial infarction (MI).** Follow-up results from thisstudy, presented at the European Society of CardiologyCongress 2008, have demonstrated that the benefits ofimmediate angioplasty were still evident at 1 year.

The study involved 600 patients with ST-elevation MIpresenting within 12 hours of symptom onset, whowere randomised for urgent transfer to an angioplastyfacility after thrombolysis with abciximab and reteplase,or thrombolysis only with later transfer if required. Theincidences of death, reinfarction and refractoryischaemia at 30 days were all shown to be lower in theimmediate transfer group.

At 1 year, the composite endpoint (combinedincidences of death, reinfarction, refractory ischaemia,rehospitalisation for heart failure or stroke) was 30.1%lower in the immediate transfer group than the standardcare group (p = 0.08). Adding revascularisation to thecomposite endpoint increased the between-groupdifference to a statistically significant 56.9%.

In an accompanying discussion, Dr W DouglasWeaver from the Henry Ford Heart and VascularInstitute, Detroit, USA, noted that the thrombolyticregimen used was unconventional, and it is unknownwhether clopidogrel or another oral antiplatelet mayhave been as or more effective than abciximab. DrWeaver maintained that it is not always best to urgentlytransfer all patients for angioplasty "neat", since earlypharmacological treatment is "a good initial therapy".* Combined Abciximab REteplase Stent Study in Acute MyocardialInfarction; supported by grants from Eli Lilly and Biotronik** See Inpharma 1604 p6; 801069921

Zmudka KZ. One-year results of the Combined Abciximab Reteplase Stent Studyin Acute Myocardial Infarction (CARESS-in-AMI) trial. ESC Congress 2008:Annual Congress of the European Society of Cardiology (Late Breaking Abstr.):(plus oral presentation) abstr. 981, 30 Aug 2008. Available from: URL: http://www.escardio.org 801123575

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Inpharma 13 Sep 2008 No. 16551173-8324/10/1655-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved