38 research outputs found
IL METABOLISMO DEL MIOCARDIO ISCHEMICO IBERNATO E STORDITO: DIFFERENZA TRA NECROSI E APOPTOSI
Descrizione del metabolismo cardiaco in condidioni di adattamento o maladattamento in varie condizioni patologiche. Differenziazione dei meccanismi della morte cellulare per necrosi e per apoptos
Single or high-dose bolus trifiban and sirolimus eluting stent versus abicixamab and bare metal stent in acute myocardial infarction (STRATEGY Study)
High-dose bolus tirofiban and sirolimus-eluting stent versus abciximab and bare metal stent in acute myocardial infarction (STRATEGY) study
none9Summary. Background: Primary bare metal stenting and
abciximab infusion are currently considered the best available
reperfusion strategy for acute ST-segment elevation
myocardial infarction (STEMI). Sirolimus eluting stents
(SES), compared to bare metal stent (BMS), greatly reduce
the incidence of binary restenosis and target vessel revascularisation
(TVR), but their use on a routine basis results in a
significant increase in medical costs.With current European
list prices, the use of tirofiban instead of abciximab would
save enough money to absorb the difference between SES
and BMS.
Aim: To assess whether in patients with STEMI the combination
of SES with high dose bolus (HDB) tirofiban results
in a similar incidence of major cardiovascular events
(MACE) but in a lower binary restenosis rate after six
months compared to BMS and abciximab.
Methods and Results: 160 patients are required to satisfy
the primary composite end-point, including MACE and
binary restenosis. The study is ongoing: the current paper
focuses on the methodology and demography of the
first 100 patients so far enrolled. Patients randomised to
HDB tirofiban (n = 50, mean age: 62 ± 12, 40 males)
and abciximab (n = 50, mean age: 63 ± 12, 38 males) do
not differ for medical history, presentation profile, medications
at discharge, angiographic profile and creatine-kinase
MB-fraction at peak.
Conclusions: The results of the trial will be available by
the end of 2004: they will be crucial for the cardiologists to
know whether the gold standard for AMI treatment should
be reconsidered after the introduction of SES into the
clinical practice.noneVALGIMIGLI M; PERCOCO G; CICCHITELLI G; MALAGUTTI P; CAMPO G; FERRARI F; BARBIERI D; ANSANI L; R. FERRARIValgimigli, M; Percoco, G; Cicchitelli, G; Malagutti, P; Campo, Gianluca Calogero; Ferrari, F; Barbieri, D; Ansani, L; Ferrari, Robert
Gauge symmetry breaking and emergence of Clebsch-dual electromagnetic field as a model of dressed photons
New and old strategies to afford the liberal use of drug-eluting stents in real-life scenarios
New and old strategies to afford the liberal use of drug-eluting stents in real-life scenarios
Drug-eluting stents represent one of the most important improvements in interventional
cardiology by decreasing the rate of restenosis dramatically. However, at
present, cost constraints and a lack of incremental reimbursement have limited
their utilization in daily practice in many countries, including Europe. Strategies to
implement the liberal use of sirolimus-eluting stents (SES), especially in the primary
percutaneous coronary intervention setting where the cost-effectiveness profile
could be less favourable, without affecting medical expenditure are presented and
discussed. To project the potential cost-effectiveness of SES-supported multivessel
treatment compared with that of coronary artery bypass grafting, a decisionanalytical
model was developed from a payer’s perspective on the basis of data
derived from the current Italian health-care system