caa a22 4500 475824431 CHVBK 20180406123827.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1023/A:1018707023127 doi (NATIONALLICENCE)springer-10.1023/A:1018707023127 Drip and Ship: A New Strategy for the Treatment of Acute Coronary Syndromes [Elektronische Daten] [Hal Chadow, Ruth Hauptman, Michael VanAuker, Shahrokh Rafii, Moshe Gunsburg, Lorraine Giarraffa, Joel Strom] Glycoprotein (GP) IIb/IIIa inhibitors block the final common pathway of platelet aggregation by preventing fibrinogen from binding to the GP IIb/IIIa platelet receptor. In patients with unstable angina (UA) or a non-Q wave myocardial infarction (NQWMI), including those with UA refractory to medical therapy, these agents decrease the risk of death, myocardial infarction (MI), and recurrent ischemia. Most patients with acute coronary syndromes are managed in hospitals without on-site angioplasty capabilities and often require transfer for an interventional procedure. We propose that GP IIb/IIIa inhibitors can be safely initiated at the referring hospital. We studied 20 patients with UA/NQWMI in whom therapy with a GP IIb/IIIa inhibitor, in addition to standard medical therapy, was initiated prior to transfer for an urgent percutaneous coronary intervention (PCI) ("drip and ship”). The primary end point was a composite of death, MI, and recurrent ischemia at 30 days. Twelve patients were treated with abciximab, 5 patients were treated with tirofiban, and 3 patients initially treated with tirofiban were converted to abciximab. Procedural success occurred in 33 out of 36 (92%) lesions and 18 out of 20 (90%) patients. At 30 days, 4 out of 20 (20%) patients had recurrent ischemia. The PTCA sites were widely patent in the 3 patients who underwent repeat angiography. The fourth patient had an unsuccessful PCI and was referred for coronary artery bypass surgery. There were no MIs or deaths. Patients who require transfer for an urgent PCI can be managed safely and efficaciously by initiating a GP IIb/IIIa inhibitor, in addition to standard medical therapy, prior to transfer. Kluwer Academic Publishers, 2000 platelet aggregation inhibitors nationallicence unstable angina nationallicence angioplasty nationallicence coronary artery disease nationallicence Chadow Hal The Brookdale University Hospital and Medical Center Brooklyn, New York, USA aut Hauptman Ruth SUNY Health Science Center, Brooklyn, New York, USA aut VanAuker Michael SUNY Health Science Center, Brooklyn, New York, USA aut Rafii Shahrokh SUNY Health Science Center, Brooklyn, New York, USA aut Gunsburg Moshe SUNY Health Science Center, Brooklyn, New York, USA aut Giarraffa Lorraine SUNY Health Science Center, Brooklyn, New York, USA aut Strom Joel SUNY Health Science Center, Brooklyn, New York, USA aut Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 10/1(2000-08-01), 77-82 0929-5305 10:1<77 2000 10 11239 https://doi.org/10.1023/A:1018707023127 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1023/A:1018707023127 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Chadow Hal The Brookdale University Hospital and Medical Center Brooklyn, New York, USA aut NATIONALLICENCE 700 1- Hauptman Ruth SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 700 1- VanAuker Michael SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 700 1- Rafii Shahrokh SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 700 1- Gunsburg Moshe SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 700 1- Giarraffa Lorraine SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 700 1- Strom Joel SUNY Health Science Center, Brooklyn, New York, USA aut NATIONALLICENCE 773 0- Journal of Thrombosis and Thrombolysis Kluwer Academic Publishers 10/1(2000-08-01), 77-82 0929-5305 10:1<77 2000 10 11239 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer