Open AccessRescue use of abciximab improves regional left ventricular function after early incomplete reperfusion in acute myocardial infarction
Author(s) -
Cho GooYeong,
Lee Cheol Whan,
Hong MyeongKi,
Kang DukHyun,
Song JaeKwan,
Kim JaeJoong,
Park SeongWook,
Park SeungJung
Publication year - 2001
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960240305
Subject(s) - medicine , abciximab , myocardial infarction , timi , cardiology , thrombolysis , ejection fraction , angioplasty , streptokinase , reperfusion therapy , conventional pci , heart failure
Background : Abciximab was shown to have important beneficial effects beyond the maintenance of epicardial coronary artery patency. However, it remains uncertain whether abciximab may lead to a better functional outcome in patients with acute myocardial infarction (AMI) and with incomplete reperfusion after primary angioplasty (PA). Hypothesis : The study aimed to evaluate whether rescue use of abciximab may lead to a better functional outcome in such patients. Methods : The study included 25 patients with first AMI who met the following criteria: (1) total occlusion of the infarct‐related artery, (2) PA within 12 h of symptom onset, (3) postprocedural diameter stenosis < 30%, and final Thrombolysis in Myocardial Infarction (TIMI) flow grade 2. Echocardiographic examination was performed before and on Days 7 and 30 after PA. The study population was divided into two groups: Group 1 (usual care, n = 13) and Group 2 (rescue use of abciximab, n = 12). Baseline characteristics were similar between the two groups. Results : Peak level of creatine kinase was higher in Group 1 than in Group 2 (5,800 ± 2,700 vs. 3,800 ± 2,000 U/l, p < 0.05). At 1 month follow‐up, infarct zone wall motion score index (2.71 ± 0.26 vs. 2.05 ± 0.63, p < 0.01) and left ventricular (LV) volume indices were smaller in Group 2 than in Group 1, whereas LV ejection fraction was higher in Group 2 than in Group 1 (52.1 ± 7.8 vs. 42.1 ± 6.4, p < 0.01). At 1‐month, abciximab was the only independent predictor of wall motion recovery index by multiple regression analysis. Conclusions : Rescue use of abciximab may reduce the infarct size in patients with AMI and TIMI grade 2 flow after PA, which may improve the recovery of regional LV function.