Marko Noc

Slovenia Medical, Maribor, Maribor, Slovenia

Are you Marko Noc?

Claim your profile

Publications (90)416.24 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: We investigated the impact of intensified postresuscitation treatment in comatose survivors of out-of-hospital cardiac arrest (OHCA) of presumed cardiac etiology according to the initial rhythm at the emergency medical team arrival.
    Resuscitation 07/2014; · 4.10 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion ("ACS" lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and safe but highly effective and there is evidence of improved survival with good neurological outcome. PCI of the culprit lesion is the primary goal while PCI of stable obstructive lesions may be postponed unless post-resuscitation cardiogenic shock is present.
    World journal of cardiology. 06/2014; 6(6):444-8.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation myocardial infarction (STEMI) and high-risk non-ST-segment elevation -ACS (NSTE-ACS) without OHCA and should undergo immediate (if STEMI) or rapid (less than two hours if NSTE-ACS) coronary invasive strategy. Comatose survivors of OHCA with ECG criteria for STEMI on the post-resuscitation ECG should be admitted directly to the catheterisation laboratory. For patients without STEMI ECG criteria, a short "emergency department or intensive care unit stop" is advised to exclude non-coronary causes. In the absence of an obvious non-coronary cause, CAG should be performed as soon as possible (less than two hours), in particular in haemodynamically unstable patients. Immediate PCI should be mainly directed towards the culprit lesion if identified. Interventional cardiologists should become an essential part of the "survival chain" for patients with OHCA. There is a need to centralise the care of patients with OHCA to experienced centres.
    EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 05/2014; 10(1):31-7. · 3.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aims: To investigate the effects of clopidogrel and eptifibatide on platelet reactivity in patients resuscitated from cardiac arrest undergoing percutaneous coronary intervention (PCI) and hypothermia. Methods and results: VerifyNow® and Multiplate® aggregometry were used before, and 4, 12, 22 and 48 hours after 600 mg clopidogrel treatment in 28 post-cardiac arrest hypothermic patients and in 14 normothermic patients with acute coronary syndrome. Basal platelet reactivity after stimulation with iso-thrombin receptor-activating peptide (TRAP) and PAR4-activating peptide (BASE) was significantly lower in the post-cardiac arrest group and persisted up to 48 hours. The antiplatelet effect of clopidogrel measured by VerifyNow and expressed as% inhibition was significantly lower in the post-cardiac arrest group. It was close to zero with an increase to only around 10% after 48 hours. Post-cardiac arrest patients receiving eptifibatide showed profound platelet inhibition measured by both VerifyNow IIb/IIIa and Multiplate TRAP tests for at least 22 hours after administration. Conclusions: Post-resuscitation syndrome with ongoing hypothermia is associated with decreased platelet reactivity. Clopidogrel loading does not significantly affect platelet function during the first 48 hours. This is in contrast with eptifibatide which produces profound platelet inhibition, and may be used to bridge insufficient inhibition by clopidogrel.
    EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 05/2014; · 3.17 Impact Factor
  • Source
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion therapy in ST-elevation myocardial infarction (STEMI). We conducted this study to evaluate the contemporary status on the use and type of reperfusion therapy in patients admitted with STEMI in the European Society of Cardiology (ESC) member countries. Methods and results A cross-sectional descriptive study based on aggregated country-level data on the use of reperfusion therapy in patientsadmitted with STEMI during 2010 or 2011. Thirty-seven ESC countries were able to provide data from existing national or regional registries. In countries where no such registries exist, data were based on best expert estimates. Data were collected on the use of STEMI reperfusion treatment and mortality, the numbers of cardiologists, and the availability of PPCI facilities in each country. Our survey provides a brief data summary of the degree of variation in reperfusion therapy across Europe. The number of PPCI procedures varied between countries, ranging from 23 to 884 per million inhabitants. Primary percutaneous coronary intervention and thrombolysis were the dominant reperfusion strategy in 33 and 4 countries, respectively. The mean population served by a single PPCI centre with a 24-h service 7 days a week ranged from 31 300 inhabitants per centre to 6 533 000 inhabitants per centre. Twenty-seven of the total 37 countries participated in a former survey from 2007, and major increases in PPCI utilization were observed in 13 of these countries. Conclusion: Large variations in reperfusion treatment are still present across Europe. Countries in Eastern and Southern Europe reported that a substantial number of STEMI patients are not receiving any reperfusion therapy. Implementation of the best reperfusion therapy as recommended in the guidelines should be encouraged.
    European Heart Journal 01/2014; · 14.10 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Hypothermia has been reported to reduce infarct size (IS) in patients with ST segment elevation myocardial infarction (STEMI). We aimed to confirm the cardioprotective effects of hypothermia using a combination of cold saline and endovascular cooling. Methods In a multi-center study, 120 patients with STEMI (<6 hours) planned to undergo percutaneous coronary intervention were randomized to hypothermia induced by rapid infusion of 600-2000 ml of cold saline and endovascular cooling or standard of care. Hypothermia was initiated before PCI and continued for 1 hr. after reperfusion. The primary endpoint was IS as % of myocardium at risk (IS/MaR), assessed by cardiac magnetic resonance imaging at 4±2 days. Results Symptom to randomization was 129±56 vs. 132±64 minutes (mean±SD), hypothermia vs. control. Patients randomised to hypothermia achieved a core body temperature of 34.7°C before reperfusion with a 9 min longer door-to-balloon time. IS/MaR was not significantly reduced (hypothermia: 40.5, 29.3-57.8 vs. control: 46.6, 37.8-63.4 (%, interquartile range (IQR), relative reduction 13%, p=0.15). The incidence of heart failure was lower with hypothermia at 45±15 days (3% vs. 14%, p<0.05), with no mortality. Exploratory analysis of early anterior infarctions (0-4h) found reduction in IS/MaR of 33%, (p<0.05) and an absolute reduction of IS/left ventricular volume of 6.2%. (p=0.15). Conclusion Hypothermia induced by cold saline and endovascular cooling was feasible, safe, and rapidly reduced core temperature with minor reperfusion delay. The primary endpoint of IS/MaR was not significantly reduced. Lower incidence of heart failure and a possible effect among early anterior STEMI needs confirmation.
    Journal of the American College of Cardiology 01/2014; · 14.09 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cardiogenic shock represents the leading cause of death in hospitalized patients with acute coronary syndromes. Immediate revascularization, either percutaneous or surgical, currently represents the only intervention of proven benefit. Despite the lack of such proof, intraaortic balloon pump (IABP) and vasoactive drugs are typically used to improve hemodynamic stability on top of revascularization. Mechanical circulatory support devices beyond IABP such as Impella, TandemHeart and venoarterial extracorporeal membrane oxygenation (VA ECMO) are hemodynamically even more effective. Despite the lack of proven survival benefit, this technology might be lifesaving in case of profound hemodynamic deterioration in the catheterization laboratory. We describe a case of profound cardiac shock due to complicated coronary artery disease, recurrent cardiac arrest during PCI, intraarrest PCI intra-aortic balloon pump insertion and successful resuscitation after venoarterial ECMO placement. Complete revascularization was achieved following ECMO insertion and patient was discharged home on day 29 with no neurological sequelae with ejection fraction of 40%.
    Cor et vasa 01/2014;
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hypertension is a well-known risk factor for atherosclerosis. However, data on the impact of hypertension in patients with ST elevation myocardial infarction (STEMI) are inconsistent and mainly related to studies performed in the thrombolytic era, with very few data on patients undergoing primary angioplasty. The aim of the present study was to evaluate the impact of hypertension on distal embolization, myocardial perfusion, and mortality in patients with STEMI undergoing primary percutaneous coronary intervention. Our population is represented by 1,662 patients undergoing primary angioplasty for STEMI included in the Early Glycoprotein IIb-IIIa inhibitors in Primary angioplasty database. Myocardial perfusion was evaluated by myocardial blush grade and ST segment resolution. Follow-up data were collected within 1 year after primary angioplasty. Hypertension was observed in 700 patients (42.1%). Hypertension was associated with more advanced age (p <0.001), female gender (p <0.001), diabetes (p <0.001), hypercholesterolemia (p <0.001), previous revascularization (p <0.001), anterior myocardial infarction (p = 0.006), longer ischemia time (p = 0.03), more extensive coronary artery disease (p = 0.002), more often treated with abciximab (p <0.001), and less often smokers (p <0.001). Hypertension was associated with impaired postprocedural myocardial blush grade 2 to 3 (68.2% vs 74.2%, p = 0.019) and complete ST segment resolution (51.7% vs 61.1%, p = 0.001). By a mean follow-up of 206 ± 158 days, 70 patients (4.3%) had died. Hypertension was associated with a greater mortality (6.2% vs 2.9%, hazard ratio 2.31, 95% confidence interval 1.42 to 3.73, p <0.001), confirmed after correction for baseline confounding factors (hazard ratio 1.82, 95% confidence interval 1.03 to 3.22, p <0.001). In conclusion, this study showed that among patients with STEMI undergoing primary angioplasty, hypertension is associated with impaired reperfusion and independently predicts 1-year mortality.
    The American journal of cardiology 08/2013; · 3.58 Impact Factor
  • Peter Radsel, Marko Noc
    Resuscitation 06/2013; · 4.10 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Primary angioplasty has been shown to be superior to thrombolysis. However, previous reports have shown a negative impact of longer time-to-treatment on myocardial perfusion and survival even with mechanical reperfusion. However, these deleterious effects might potentially be overcome by an extensive use of glycoprotein (Gp) IIb-IIIa inhibitors. Thus, the aim of the current study was to evaluate the prognostic role of the interval from symptoms onset to reperfusion in a large cohort of patients undergoing primary angioplasty with Gp IIb-IIIa inhibitors. METHODS: Our population is represented by 1560 patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI) included in the EGYPT (Early Glycoprotein IIb-IIIa Inhibitors in Primary Angiography) database. Myocardial perfusion was evaluated by angiography or ST-segment resolution, whereas infarct size was estimated by using peak creatine kinase and creatine kinase-MB (CK-MB). Follow-up data were collected between 30 days and 1 year after primary angioplasty. RESULTS: Time-to-treatment was significantly associated with age and female sex, diabetes and previous myocardial infarction (MI), but inversely related to smoking. Time-to-treatment affected the rate of postprocedural thrombolysis in myocardial infarction (TIMI) 3 flow (P < 0.0001), myocardial blush grade 2-3 (P = 0.052), complete ST-resolution (P < 0.0001) and distal embolization (P = 0.038). This relationship was confirmed after correction for baseline confounding factors for postprocedural TIMI 3 flow (P = 0.008) and complete ST-segment resolution (P = 0.003). Furthermore, time-to-treatment significantly affected enzymatic infarct size, even after correction for baseline confounding factors [odds ratio (OR) 95% confidence interval (95% CI) = 1.002 (1.001-1.003), P = 0.004]. At 208 ± 160 days follow-up, time-to-treatment was associated with a significantly higher mortality (P = 0.006). The impact was confirmed when time-to-treatment was evaluated as a continuous variable (P < 0.001), even after correction for baseline confounding factors [age, sex, diabetes, smoking, hypertension, previous myocardial infarction (MI), preprocedural TIMI 3 flow, multivessel disease, coronary stenting and early Gp IIb-IIIa inhibitors] (P = 0.001). CONCLUSION: This study showed that time-to-treatment is a major determinant of mortality in ST-segment elevation myocardial infarction patients undergoing primary angioplasty. Impaired epicardial and myocardial perfusion and larger infarct size associated with longer ischemia time contribute to explain this finding.
    Journal of Cardiovascular Medicine 03/2013; · 2.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite mechanical reperfusion, the outcome is still unsatisfactory in elderly patients with ST-segment elevation myocardial infarction (STEMI). The vast majority of studies have been conducted without extensive use of glycoprotein (Gp) IIb-IIIa inhibitors, which have been associated with improved perfusion and survival. Thus the aim of the current study was to evaluate the impact of age on the angiographic and clinical outcome patients with STEMI undergoing primary angioplasty with Gp IIb-IIIa inhibitors. Our population is represented by a total of 1,662 patients undergoing primary angioplasty for STEMI included in 11 randomized trials comparing early versus late administration of Gp IIb-IIIa inhibitors. Myocardial perfusion was evaluated by myocardial blush grade and ST-segment resolution. Follow-up data were collected between 30 days and 1 year after primary angioplasty. A total of 231 (13.9 %) patients were older than 75 years. Elderly patients showed a larger prevalence of female gender, hypertension, and diabetes, more advanced Killip class at presentation and longer time to treatment, but a smaller prevalence of smoking. All patients were treated with GP IIb-IIIa inhibitors. Elderly patients showed a significantly impaired postprocedural thrombolysis in myocardial infarction (TIMI) flow (TIMI 0-2: 17.7 vs 10.3 %, P = 0.002) and myocardial perfusion (myocardial blush grade 0-1: 38.3 vs 26.5 %, P = 0.001), and higher prevalence of distal embolization (19.2 vs 9.8 %, P < 0.001), whereas no difference was observed in terms of ST-segment resolution. At follow-up, elderly patients showed a significantly higher mortality (3.2 vs 11.0 %, hazard ratio (HR) (95 % confidence interval (CI)) = 3.78 (2.31-6.16), P < 0.001), which was confirmed after adjustment for baseline confounding factors (HR (95 % CI) = 5.01 (2.63-9.55), P < 0.0001). This study showed that among patients with STEMI undergoing primary angioplasty, advanced age is an independent predictor of mortality after primary angioplasty. Higher rates of distal embolization and poor myocardial perfusion, in addition to the worse risk profile, contribute toward explaining the impact of aging on mortality.
    Heart and Vessels 03/2013; · 2.13 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Justification Bien que l’angioplastie primaire aboutisse à un flux TIMI 3 chez la majorité des patients ayant un infarctus du myocarde avec sus-décalage du segment ST (STEMI), la recanalisation épicardique ne garantit pas une reperfusion optimale dans une proportion significative de patients. L’influence de la présence de lésions coronaires pluritronculaires sur la reperfusion myocardique ainsi que la survie au décours d’une angioplastie primaire n’a pas été évaluée de façon détaillée. Objectifs Évaluer l’impact de lésions coronaires pluritronculaires sur la perfusion myocardique et la survie au sein d’une cohorte de patients ayant un STEMI traité par angioplastie primaire et sous anti-GPIIb-IIIa. Méthode Cette analyse a inclus 1494 patients bénéficiant d’une angioplastie primaire, inclus dans la base EGYPT. La perfusion myocardique a été évaluée angiographiquement ou sur la résolution du sus-décalage du segment ST et la taille de l’infarctus a été évaluée sur le pic de CPK-MB. Les données de suivi ont été collectées à j30 et à un an après l’angioplastie primaire. Résultats Les lésions coronaires pluritronculaires ont été observées chez 870 patients (58,2 %). L’étendue de la maladie coronaire était associée à l’âge, au diabète, à l’hypertension artérielle, à un antécédent d’infarctus du myocarde, à un antécédent de revascularisation coronaire, à un traitement par abciximab, et à une durée prolongée de l’ischémie et était associée de façon indépendante à une altération de la perfusion myocardique évaluée en angiographie (odds ratio ajusté 1,18, IC 95 % 1,01–1,4, p = 0,049). À j208 ± 160, l’étendue de la maladie coronaire est associée de façon indépendante à une surmortalité (hazard ratio ajusté 1,54, IC 95 % 1,06–2,24, p = 0,022). Conclusion Parmi les patents ayant un STEMI traité par angioplastie primaire, sous anti-GP IIb-IIIA, l’étendue de la maladie coronaire est attestée de façon indépendante à une altération de la perfusion myocardique et à la survie.
    Archives of cardiovascular diseases 03/2013; 106(3):155–161. · 0.66 Impact Factor
  • Kardiologia polska 01/2013; 71(3):286-9. · 0.54 Impact Factor
  • Resuscitation 09/2012; · 4.10 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Considerable interest has been focused in recent years on the role of distal embolisation as a major determinant of impaired reperfusion after primary angioplasty for STEMI. The aim of the current study was to evaluate in a large cohort of STEMI patients undergoing primary angioplasty with glycoprotein (Gp) IIb-IIIa inhibitors, whether the impact of distal embolisation on myocardial perfusion and survival may depend on time-to-treatment. Our population is represented by 1,182 patients undergoing primary angioplasty for STEMI included in the EGYPT database. Patients were grouped according to time-to-treatment (<3 hours, 3-6 hours, >6 hours). Distal embolisation was defined as an abrupt "cutoff" in the main vessel or one of the coronary branches of the infarct-related artery, distal to the angioplasty site. Myocardial perfusion was evaluated by angiography or ST-segment resolution, whereas infarct size was estimated by using peak creatine kinase (CK) and CK-MB. Follow-up data were collected between 30 days and one year after primary angioplasty. Distal embolisation was observed in 132 patients (11.1%) and tended to occur more frequently in late presenters (p=0.067). Patients with distal embolisation less often had post-procedural Thrombolysis In Myocardial Infarction (TIMI) 3 flow (p<0.001), post-procedural myocardial blush grade (MBG) 2-3 (p<0.001), complete ST-segment resolution (p=0.021) and larger infarct size (p=0.012). Distal embolisation was associated with a significantly higher mortality (9.2% vs. 2.7%, heart rate [HR] [95% CI]=3.41 [1.73-6.71], p<0.0001). The impact of distal embolisation on myocardial perfusion and survival persisted for all time intervals. This study showed that among STEMI patients treated with Gp IIb-IIIa inhibitors, the negative impact of distal embolisation on myocardial perfusion and mortality is independent of the time from symptom onset to balloon angioplasty.
    EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 08/2012; 8(4):470-6. · 3.17 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Despite optimal epicardial recanalization, primary angioplasty for ST-elevation myocardial infarction (STEMI) is still associated with suboptimal reperfusion in a relatively large proportion of patients. The aim of the current study was to evaluate the impact of preprocedural TIMI flow on myocardial perfusion, distal embolization, and survival among STEMI patients undergoing primary angioplasty with glycoprotein (GP) IIb/IIIa inhibitors. Our population is represented by a total of 1637 patients undergoing primary angioplasty for STEMI treated with GP IIb/IIIa inhibitors. Myocardial perfusion was evaluated by myocardial blush grade and ST-segment resolution. Follow-up data were collected between 30 days and 1 year after primary angioplasty. Poor preprocedural TIMI flow (TIMI 0-1) was observed in 1039 patients (63.5%), and was associated with higher Killip class at presentation (P=.006), longer time-to-treatment (P=.03), less often with early administration of GP IIb/IIIa inhibitors (P<.001), impaired postprocedural epicardial (P=.001) and myocardial perfusion (determined by myocardial blush grade, P<.001 and/or ST-segment resolution (P<.001), and distal embolization (P=.041). At 206 ± 158 days follow-up, poor preprocedural recanalization was associated with a significantly higher mortality (adjusted odds ratio, 0.58; 95% CI, 0.34-0.96; P=.034). This study shows that among patients with STEMI undergoing primary angioplasty with GP IIb/IIIa inhibitors, poor preprocedural TIMI flow is associated with higher incidence of distal embolization and impaired epicardial and myocardial perfusion, and significantly higher mortality.
    The Journal of invasive cardiology 07/2012; 24(7):324-7. · 1.57 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Extracorporeal life support (ELS) is emerging as a standard treatment option for acute respiratory and/or cardiac failure. In this article we describe our first year of experience with ELS activity in adult medical patients in our center. Veno-venous extracorporeal membrane oxygenation (VV ECMO) support was applied in cases of severe acute respiratory distress syndrome (ARDS) not responsive to conventional treatments. The use of veno-arterial (VA) ECMO support was reserved for cases of cardiac shock refractory to standard treatment and cardiac arrests not responding to conventional resuscitation. A total of 19 patients were treated with ELS during the first year of activity. Eight of these received VV ECMO for ARDS of various etiologies, with a survival rate of 63%. Eleven patients received VA ECMO support due to cardiac failure (2 post-resuscitation). Survival in this group was 45%. We report our results, including complications and organizational issues that we encountered, and describe protocol improvements developed over the short period of time since ELS treatment has been implemented in our center.
    The International journal of artificial organs 04/2012; 35(5):392-9. · 1.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: We report an 18-year-old ice skater with acute lymphoblast leukemia. She developed Staphylococcus epidermidis bacteremia, severe sepsis, septic shock, and ARDS following chemotherapy-induced severe bone marrow failure. She was successfully treated with extraordinary life support measures, which included extracorporeal membrane oxygenation, double lumen lung ventilation for management of hemoptysis, and lung assist membrane ventilation. After 57 days of ICU treatment and a year of rehabilitation, the patient has fully regained her functional status, is now finishing high school, and is ice skating again.
    Respiratory care 02/2012; 57(7):1178-81. · 2.03 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Even although time to treatment has been shown to be a determinant of mortality in primary angioplasty, the potential benefits are still unclear from early pharmacological reperfusion by glycoprotein (Gp) IIb-IIIa inhibitors. Therefore, the aim of this meta-analysis was to combine individual data from all randomized trials conducted on upstream as compared with late peri-procedural abciximab administration in primary angioplasty. The literature was scanned using formal searches of electronic databases (MEDLINE and EMBASE) from January 1990 to December 2010. All randomized trials on upstream abciximab administration in primary angioplasty were examined. No language restrictions were enforced. We included a total of seven randomized trials enrolling 722 patients, who were randomized to early (n = 357, 49.4%) or late (n = 365, 50.6%) peri-procedural abciximab administration. No difference in baseline characteristics was observed between the two groups. Follow-up data were collected at a median (25th-75th percentiles) of 1095 days (720-1967). Early abciximab was associated with a significant reduction in mortality (primary endpoint) [20% vs. 24.6%; hazard ratio (HR) 95% confidence interval (CI) = 0.65 (0.42-0.98) P = 0.02, P(het) = 0.6]. Furthermore, early abciximab administration was associated with a significant improvement in pre-procedural thrombolysis in myocardial infarction (TIMI) 3 flow (21.6% vs. 10.1%, P < 0.0001), post-procedural TIMI 3 flow (90% vs. 84.8%, P = 0.04), an improvement in myocardial perfusion as evaluated by post-procedural myocardial blush grade (MBG) 3 (52.0% vs. 43.2%, P = 0.03) and ST-segment resolution (58.4% vs. 43.5%, P < 0.0001) and significantly less distal embolization (10.1% vs. 16.2%, P = 0.02). No difference was observed in terms of major bleeding complications between early and late abciximab administration (3.3% vs. 2.3%, P = 0.4). This meta-analysis shows that early upstream administration of abciximab in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI) is associated with significant benefits in terms of pre-procedural epicardial re-canalization and ST-segment resolution, which translates in to significant mortality benefits at long-term follow-up.
    Journal of Thrombosis and Haemostasis 09/2011; 9(12):2361-70. · 6.08 Impact Factor

Publication Stats

2k Citations
416.24 Total Impact Points

Institutions

  • 2002–2014
    • Slovenia Medical
      Maribor, Maribor, Slovenia
    • Children's Hospital Los Angeles
      • Division of Hospital Medicine
      Los Angeles, California, United States
  • 2000–2014
    • University of Ljubljana
      Lubliano, Ljubljana, Slovenia
  • 1990–2014
    • Ljubljana University Medical Centre
      • Department of Intensive Internal Medicine
      Lubliano, Ljubljana, Slovenia
  • 2009–2012
    • Azienda Ospedaliero Universitaria Maggiore della Carità
      • Department of Cardiology 2
      Novara, Piedmont, Italy
  • 2011
    • University Medical Centre Maribor
      • Department of Cardiology and Angiology
      Maribor, Mestna Obcina Maribor, Slovenia
  • 2003
    • Splošna Bolnišnica Izola
      Ižla, Izola-Isola, Slovenia
  • 1992–1996
    • Texas Tech University Health Sciences Center
      • Department of Medicine
      Lubbock, TX, United States