Mukherjee Debabrata, Topol Eric J, Bertrand Michel E, Kristensen Steen D, Herrmann Howard C, Neumann Franz-Josef, Yakubov Steven J, Bassand Jean-Pierre, McClure Rick R, Stone Gregg W, Ardissino Diego, Moliterno David J
Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY 40536-0200, USA.
Eur Heart J. 2005 Dec;26(23):2524-8. doi: 10.1093/eurheartj/ehi459. Epub 2005 Aug 17.
Compared with placebo, abciximab has been associated with mortality reduction at late follow-up. The TARGET trial was performed to test whether tirofiban and abciximab provide similar efficacy outcomes among patients undergoing non-emergent, stent-based percutaneous coronary intervention. We report here the 1-year mortality of the study population.
In 18 countries at 149 hospitals, 4,809 patients undergoing elective or urgent stent implantation were randomly assigned a bolus and infusion of tirofiban or abciximab. Ischaemic events were assessed at 30 days and 6 months and mortality was assessed at 1 year. We previously reported that abciximab was superior to tirofiban considering the composite rate of death or myocardial infarction at 30 days among all patients and at 6 months among those with an acute coronary syndrome (ACS). At 1-year follow-up death occurred in 46 (1.9%) patients who received tirofiban and 42 (1.7%) patients who received abciximab (hazard ratio 1.10, 95% CI 0.72-1.67; P=0.660). Mortality rates for patients with ACS were 2.3% with tirofiban vs. 2.2% with abciximab (hazard ratio 1.03, 95% CI 0.64-1.67; P=0.897) and those without ACS were 1.4 vs. 1.0% (hazard ratio 1.32, 95% CI 0.56-3.13; P=0.530).
At 1 year, tirofiban provided a similar level of survival benefit compared with abciximab.
与安慰剂相比,阿昔单抗在后期随访中与死亡率降低相关。进行TARGET试验以测试替罗非班和阿昔单抗在接受非紧急、基于支架的经皮冠状动脉介入治疗的患者中是否提供相似的疗效结果。我们在此报告研究人群的1年死亡率。
在149家医院所在的18个国家,4809例接受择期或紧急支架植入的患者被随机分配接受替罗非班或阿昔单抗的推注和输注。在30天和6个月时评估缺血事件,在1年时评估死亡率。我们之前报告过,考虑到所有患者在30天时以及急性冠状动脉综合征(ACS)患者在6个月时死亡或心肌梗死的复合发生率,阿昔单抗优于替罗非班。在1年随访时,接受替罗非班的46例(1.9%)患者和接受阿昔单抗的42例(1.7%)患者死亡(风险比1.10,95%置信区间0.72 - 1.67;P = 0.660)。ACS患者的死亡率,替罗非班为2.3%,阿昔单抗为2.2%(风险比1.03,95%置信区间0.64 - 1.67;P = 0.897),无ACS患者的死亡率分别为1.4%和1.0%(风险比1.32,95%置信区间0.56 - 3.13;P = 0.530)。
在1年时,替罗非班与阿昔单抗相比提供了相似水平的生存获益。