Comparison of Two Treatment Strategies in Patients With an Acute Coronary Syndrome Without ST Elevation
Status:
Terminated
Trial end date:
2013-07-01
Target enrollment:
Participant gender:
Summary
The acute coronary syndrome (ACS) without ST elevation is a frequent pathology. The main
evolutionary risk of these patients is the coronary thrombosis and its self complications.
The platelets aggregation plays a major role in the physiopathology of the ACS. The
therapeutic arsenal of the anti-thrombosis essentially resting on aspirin and heparin has
been reinforced lately by the inhibitors of the glycoprotein anti GP IIb/IIIa. The profit of
these products in the ACS with or without ST elevation, associated or not to coronarography,
has clearly been demonstrated. This profit is more marked when patients are at high risk of
complications. Thus, the use of an anti GP IIb/IIIa is recommended among patients at "high
risk" for whom a coronarography is planned, in the last international recommendations of the
European Cardiology Society (ESC), the American Heart Association and the American College of
Chest Physician. Otherwise, some authors have proposed An early invasive strategy based on
coronarography with discordant results. The ideal delay of realization of this coronarography
is unknown. It varies according to the studies between 2.5 hours to 48 hours. Once again,
patients at high risk seem to benefit the more of such a strategy if it is set precociously.
Objective To compare an invasive strategy associating an early administration of tirofiban
and a coronarography achieved in the 6 hours after the randomization to a conservative
strategy in a population of high risk patients with ACS without ST elevation.
Design Multicentric, prospective, randomized study.