Document Detail


Abciximab in primary coronary angioplasty for acute myocardial infarction improves short- and medium-term outcomes.
MedLine Citation:
PMID:  9857884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to compare the outcome of primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (MI) when performed with or without the platelet glycoprotein IIb/IIIa antibody, abciximab. BACKGROUND: Abciximab improves the outcome of angioplasty but the effect of abciximab in primary angioplasty has not been investigated. METHODS: Data were collected from a computerized database. Follow-up was by telephone or review of outpatient or hospital readmission records. RESULTS: A total of 182 consecutive patients were included; 103 received abciximab and 79 did not. The procedural success rate was 95% in the two groups. At 30-day follow-up, the composite event rate of unstable angina, reinfarction, target vessel revascularization and death from all causes was 13.5% in the group of patients who did not receive abciximab, 4% (p < 0.05) in the abciximab group and 2.4% (p < 0.05) in the subgroup of patients (n = 87) who completed the 12-h abciximab infusion. At the end of follow-up (mean 7+/-4 months), the composite event rate was 32.4%, 17% (p < 0.05) and 13.1% (p < 0.01) in these three categories respectively. Abciximab bolus followed by a 12-h infusion was an independent predictor of event-free survival, in a Cox proportional hazards model (relative risk 0.49; 95% confidence interval 0.24 to 0.99; p < 0.05). CONCLUSIONS: Abciximab given at the time of primary angioplasty may improve the short- and medium-term outcome of patients with acute MI, especially when a 12-h infusion is completed.
Authors:
R R Azar; R G McKay; P D Thompson; J A Hirst; J F Mitchell; D B Fram; D D Waters; F J Kiernan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  32     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-05     Completed Date:  1999-01-05     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1996-2002     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Hartford Hospital and the University of Connecticut School of Medicine, USA. razar@bidmc.harvard.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Antibodies, Monoclonal / therapeutic use*
Female
Humans
Immunoglobulin Fab Fragments / therapeutic use*
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / mortality,  therapy*
Platelet Aggregation Inhibitors / therapeutic use*
Proportional Hazards Models
Survival Analysis
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 143653-53-6/abciximab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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