1 / 14

1 o PTCA (n=516)

Randomize. CADILLAC. Study Design. Stone et al.Circulation 2000; 102: II-664. AMI <12 hours, any age, cardiogenic shock excluded n=2,665 at 76 centers in N.A., S.A. and Europe. Angiography. no. Met angiographic criteria n=2,082 (78%). Registry n=583 (22%). yes. MultiLink stent

tonya
Download Presentation

1 o PTCA (n=516)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Randomize CADILLAC Study Design Stone et al.Circulation 2000; 102: II-664 AMI <12 hours, any age, cardiogenic shock excluded n=2,665 at 76 centers in N.A., S.A. and Europe Angiography no Met angiographic criteria n=2,082 (78%) Registry n=583 (22%) yes MultiLink stent (n=512) 1o PTCA (n=516) 1o PTCA + Abciximab (n=529) MultiLink stent + Abciximab (n=525)

  2. CADILLAC Stone. Oral presentation. AHA 1999. • 1961 patients with acute MI • Target lesion 2.5-4 mm, < 70 mm length • Randomized: • Stent vs. PTCA • Abciximab vs. placebo • Shock excluded • Rx ASA, ticlopidine, heparin • ACT 200-300 w/abciximab • ACT >350 w/placebo • Primary endpoint • 6 month death/MI/urgent intervention

  3. CADILLAC [ Presentation of acute safety / outcome data ] • No difference between groups in mortality, stroke • Trend toward fewer reinfarctions in stent pts • Trend toward less ischemia-driven TVR in stent pts • No difference between groups in ICH Stent/A Stent/P PTCA/A PTCA/P TIMI 3 flow 96.7% 92.1% 95% 94.8% Rec isch 1.2% 3.9% 1.4% 4% Bleeding 4.5% 3.5% 5.1% 3.1% Stone. Oral presentation. AHA 1999.

  4. CADILLAC Stone, TCT 2000 • 2082 patients with acute MI (2.5-4.5 mm vessels) • Shock excluded • Randomized to : • PTCA • PTCA + abciximab • Stent (Multi-link) • Stent + abciximab • Crossover allowed • Primary endpoint : MACE at 6 mo (stent vs PTCA)

  5. CADILLAC Stone, TCT 2000 Outcomes at 6 Months

  6. p = 0.001 CADILLAC Primary Endpoint - MACE at 6 Months 20% 19.3% 15% 10.9% 10% Incidence 5% 0% 0 30 60 90 120 150 180 Days to event PTCA, no abciximab Stent, no abciximab Stone et al. Circ 2000; 102: II-664

  7. CADILLAC Primary Endpoint - MACE at 6 Months 20% 15.2% 15% 10.9% 10% 5% 0% 0 30 60 90 120 150 180 Days to event PTCA, abciximab Stent, no abciximab Incidence (%) Stone et al. Circ 2000; 102: II-664

  8. CADILLAC Secondary Endpoint MACE at 30 Days No Abciximab Abciximab 10 8 7.1 p = 0.04 % of Patients 6 5.0 4 2 0 Death, Disabling Stroke, Re-MI or Ischemic TVR Stone et al. Circ 2000; 102: II-664

  9. CADILLAC Seconday Endpoint - MACE at 6 Months 20% 19.3% 15.2% 15% 10.9% 10.8% 10% Incidence (%) 5% 0% 0 30 60 90 120 150 180 Days to event PTCA, no abx PTCA, abx Stent, no abx Stent, abx Stone et al. Circ 2000; 102: II-664

  10. CADILLAC Additional Benefits of Abciximab • Thrombotic bailout • Subacute Thrombosis • Ischemic TVR • Registry Patients

  11. CADILLAC Stone, TCT 2000 Treatment Received

  12. CADILLAC 30 Day Subacute Thrombosis 1.7% P=0.07 p=0.03 1% 0.6% 0% Stone et al. Circ 2000; 102: II-664

  13. CADILLAC Ischemic TVR p=NS p<0.001 p=0.12 p<0.02 p=NS p=0.04 Stone et al. Circ 2000; 102: II-664

  14. CADILLAC Angiographic Exclusion Registry: Hospital Mortality 47% received Abx; Mortality = 4.7% w/Abx vs. 8.3% w/o Abx, p = 0.22 Treatment received(n=583) Stone et al. Circ 2000; 102: II-664

More Related