Early Zalunfiban Injection Effective for Major Heart Attack:

In patients with ST-segment elevation myocardial infarction (STEMI), early subcutaneous administration of zalunfiban significantly improved coronary artery patency and reduced the risk of adverse 30-day clinical outcomes without increasing severe bleeding. In an international, double-blind, placebo-controlled trial of 2,467 patients randomly assigned to receive zalunfiban (0.11 mg/kg or 0.13 mg/kg) or placebo at first medical contact, zalunfiban significantly improved the primary 30-day hierarchical efficacy end point—a composite ranking of death, stroke, recurrent myocardial infarction, acute stent thrombosis, heart failure, infarct size, and absence of events—compared with placebo (adjusted odds ratio, 0.79). Angiography demonstrated faster coronary blood flow with zalunfiban (median corrected frame count, 109 vs. 176). Severe or life-threatening bleeding was similar between groups (1.2% vs. 0.8%), though mild to moderate bleeding was more frequent with zalunfiban (6.4% vs. 2.5%). These findings suggest that early and fast glycoprotein IIb/IIIa inhibition with zalunfiban could enhance preintervention reperfusion and clinical outcomes in STEMI, with an acceptable safety profile. Source: https://evidence.nejm.org/