Although an interventional cardiology procedure called primary percutaneous coronary intervention (PCI) is the gold standard for treating a severe heart attack—known as an ST-segment elevation myocardial infarction (STEMI)—its success is highly time-dependent. Current oral medications are often absorbed too slowly to provide immediate protection during transit to the hospital and the actual PCI procedure, creating a critical gap in care. To address this, the CELEBRATE trial evaluated zalunfiban, a potent antiplatelet medication that acts within 15 minutes to improve patient outcomes during this critical time. Study researchers, including CVC faculty member Dr. Robert Welsh, investigated whether a single subcutaneous (under-the-skin) injection at the first point of medical contact could halt clot progression and restore blood flow more effectively than the current standard of care.
This international study randomly assigned 2,467 patients to receive either a single injection of zalunfiban or a placebo before arriving at the hospital. To measure success, researchers used a hierarchical ranking system that evaluated seven health outcomes over 30 days—ranging from the most severe, such as death or stroke, to the total size of heart muscle damage.
The results showed that patients receiving zalunfiban were significantly more likely to have a favorable recovery. Angiography imaging confirmed that the drug improved blood flow to the heart before the PCI procedure even began. In terms of safety, the study found no significant increase in severe or life-threatening bleeding compared to the placebo group, although mild to moderate bleeding did occur more frequently.
Ultimately, the trial concluded that zalunfiban administered at the first point of medical contact successfully reduces the likelihood of poor clinical outcomes and accelerates the restoration of blood flow to the heart. These results demonstrate that zalunfiban is a safe and effective treatment that can be used alongside state-of-the-art reperfusion therapy for patients experiencing a STEMI.
