Benefit of glycoprotein IIb/IIIa inhibition in patients with acute coronary syndromes and troponin t-positive status: the paragon-B troponin T substudy.

摘要: Background—Troponin T (TnT) is valuable for short- and long-term risk stratification of patients with acute coronary syndromes (ACS). It also may predict which ACS will benefit from glycoprotein (GP) IIb/IIIa blockade. Methods Results—We prospectively studied 1160 non–ST-segment elevation randomized in PARAGON-B to receive lamifiban, an intravenous GP antagonist, or placebo. TnT levels were obtained before study treatment began 24 72 hours later; assays performed by a blinded core laboratory. At baseline, 40.2% TnT-positive (≥0.1 ng/mL); these older more often male smokers. Patients positive at baseline had significantly higher rate the primary end point (composite death, myocardial [re]infarction, severe recurrent ischemia 30 days; odds ratio, 1.5; 95% CI, 1.1 2.1) than those who TnT-negative. Lamifiban was associated significant reduction (from 19.4% 11.0%, P=0...