Early versus periprocedural administration of abciximab for primary angioplasty: A pooled analysis of 6 studies


Godicke, J; Flather, M; Noc, M; Gyongyosi, M; Arntz, HR; Grip, L; Gabriel, HM; Huber, K; Nugara, F; Schroer, J; Svensson, L; Wang, DL; Zorman, S; Montalescot, G; (2005) Early versus periprocedural administration of abciximab for primary angioplasty: A pooled analysis of 6 studies. American heart journal, 150 (5). ISSN 0002-8703 DOI: https://doi.org/10.1016/j.ahj.2005.07.026

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Abstract

Background The 2004 ACC/AHA guidelines on ST-elevation myocardial infarction state that it is reasonable to start treatment with abciximab as early as possible before primary percutaneous coronary intervention (PCI). We investigated the potential benefit of early use of abciximab by pooling data from all the available studies. Methods Six prospective studies were identified that had allocated 260 patients to receive early abciximab (either prehospital or soon after the patient arrived in hospital) and 342 to receive late abciximab (at the time of PCI). Results TIMI flow grade 2 or 3 was present in 42% of the early group compared with 29% in the late group (P = .001). After PCI, 59% of patients in the early group showed ST-resolution >= 70%, compared with 41% in the late group (P = .003). The composite clinical outcome of death, new myocardial infarction, or repeat target vessel revascularization at 30 days occurred in 7.3% of the early group compared with 9.7% in the late group (odds ratio 0.73, 95% Cl 0.41-1.32) and death alone occurred in 2.7% versus 4.7%, respectively (odds ratio 0.56, 95% CI 0.23-1.39). Conclusions Early administration of abciximab improves epicardial potency (TIMI flow) before PCI and results in better myocardial tissue perfusion (ST-resolution) after the procedure, The promising effects on clinical outcomes need to be tested in larger studies.

Item Type: Article
Keywords: ACUTE MYOCARDIAL-INFARCTION, PERCUTANEOUS CORONARY INTERVENTION, GLYCOPROTEIN IIB/IIIA INHIBITORS, RANDOMIZED CLINICAL-TRIALS, REPERFUSION THERAPY, PLUS ABCIXIMAB, THROMBOLYSIS, FACILITATION, METAANALYSIS, MULTICENTER, Angioplasty, Transluminal, Percutaneous Coronary, Antibodies, Monoclonal, administration & dosage, Female, Humans, Immunoglobulin Fab Fragments, administration & dosage, Male, Middle Aged, Time Factors
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Medical Statistics
PubMed ID: 16290988
Web of Science ID: 233478800038
URI: http://researchonline.lshtm.ac.uk/id/eprint/6360

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