Myocardial Infarction Clinical Trial
Official title:
Multicentre 2x2 Factorial Randomised Study Comparing Tirofiban Administered With the Single High-Dose Bolus Versus Abciximab and Sirolimus Eluting Stent Versus Bare Metal Stent in Acute Myocardial Infarction - MULTI-STRATEGY Trial
The purpose of this study is to determine which from the four combinations tirofiban+sirolimus eluting stent (SES), tirofiban+bare metal stent (BMS), abciximab+SES, abciximab+BMS is the possible gold standard treatment for ST-segment elevation myocardial infarction in terms of efficacy and cost-efficacy.
The combination abciximab plus bare metal stent (BMS) is currently considered the standard
therapy for AMI. The use of sirolimus eluting stent (SES) is related to a reduction of the
need for urgent target vessel revascularization (TVR). With current acquisition prices for
abciximab and SES, replacing abciximab with tirofiban, administered as a single high-dose
bolus (SHDB) regimen, is a promising strategy that would preserve financial resources. In a
recent study the combination tirofiban and SES resulted to be associated to an overall lower
major adverse cardiovascular events (MACE) rate with respect to the abciximab plus BMS.
However, since no conclusion can be drawn yet regarding the relative contribution of a
specific GP IIb/IIIa inhibitor or a stent type with respect to the other, the combination of
abciximab and SES may be associated to an even lower event rate with respect to SHDB
tirofiban and SES, thus offsetting the higher initial cost.
Comparison(s): four strategies (SHDB tirofiban + BMS, SHDB tirofiban + SES, abciximab + BMS,
abciximab + SES) are compared to determine the possible gold standard treatment for
ST-segment elevation myocardial infarction in terms of efficacy and cost-efficacy.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Factorial Assignment, Masking: Open Label, Primary Purpose: Treatment
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