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Early administration of abciximab in patients with acute myocardial infarction improves angiographic and clinical outcome after primary angioplasty
Author(s) -
Beeres Saskia L.M.A.,
Oemrawsingh Pranobe V.,
Warda Hazem M.,
Bechan Ratna,
Atsma Douwe E.,
Jukema J. Wouter,
van der Wall Ernst E.,
Schalij Martin J.
Publication year - 2005
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20432
Subject(s) - medicine , abciximab , timi , mace , conventional pci , myocardial infarction , percutaneous coronary intervention , cardiology , cardiogenic shock , angioplasty , revascularization , coronary artery disease
Adjunctive use of abciximab during percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) improves clinical outcome. This study addresses the outcome of patients with AMI treated with abciximab, initiated either before transport to a PCI center (early group) or immediately upon arrival at the catheterization laboratory (late group) for primary PCI. Of 446 consecutive patients with AMI, angiographic data and clinical complications were evaluated up to 6 months after primary PCI. Patients received abciximab before transport (early group; n = 138) or just before the intervention (late group; n = 308). Baseline data, including transport time (45 ± 15 min; range, 15–60 min), were comparable in both groups. Early reperfusion was more prevalent in the early group (35% vs. late 19%; P < 0.001). Furthermore, a better final TIMI 3 flow was noted in the early group (91% vs. late 83%; P = 0.05). Although mortality reduction attributable to early abciximab treatment could not be demonstrated, major adverse cardiac events (MACE) occurred in 27% in the early group and 36% in the late group ( P = 0.05). Revascularization rates were similar, but repeat acute coronary syndromes were less frequent in the early group (11% vs. late group 20%; P = 0.04). In multivariate analysis, cardiogenic shock, out‐of‐hospital cardiac arrest, and previously known coronary artery disease were independent predictors of higher MACE rate, whereas early reperfusion and final TIMI 3 flow reduced 6‐month MACE rate. Abciximab pretreatment of patients with AMI for primary PCI results in better initial and final TIMI flow and tends to improve 6‐month clinical outcome. © 2005 Wiley‐Liss, Inc.