| Clinical outcomes following "rescue" administration of abciximab in patients undergoing percutaneous coronary angioplasty. | |
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MedLine Citation:
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PMID: 11022207 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pre-intervention administration of abciximab in patients at "high risk" for coronary angioplasty has been shown to reduce acute and long-term cardiac outcomes. The role of intra-procedural ("rescue") administration of abciximab has not been fully elucidated. We assessed the clinical outcomes associated with rescue administration of abciximab during complex percutaneous coronary interventions. We studied in-hospital and long-term (1-year) outcomes (death, myocardial infarction and target lesion revascularization) of 298 consecutive patients (78% male; age, 62 +/- 11 years; 83% with acute coronary syndrome) treated with abciximab for thrombus-containing lesions, sub-optimal angioplasty results, procedural dissections or other complications. Stents were used in 73% of procedures. Procedural success was 97.0% and overall major in-hospital complication rate was 3.0% (death, 1.3%; Q-wave myocardial infarction, 0.7%; and emergent bypass surgery, 1.0%). Most frequent angiographic complications included visible thrombus (17%), dissections (17%), threatened closure (7%), and distal embolization (7%). In-hospital non-Q wave myocardial infarction (defined as CK-MB 5 times normal) occurred in 31.0%. Out-of-hospital to one-year events included death (1.7%), Q-wave myocardial infarction (2.7%), and target lesion revascularization (15.1%); cardiac event-free survival was 82.9%. We conclude that rescue administration of abciximab is associated with relatively low in-hospital complications and favorable long-term outcome in patients with sub-optimal angioplasty results and/or procedure-related complications, although peri-procedural non-Q wave myocardial infarction rate is high. A clinical and cost-effective comparison between provisional and rescue administration of abciximab may be warranted. |
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Authors:
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S Fuchs; R Kornowski; R Mehran; L Gruberg; L F Satler; A D Pichard; K M Kent; G W Stone; M B Leon |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: The Journal of invasive cardiology Volume: 12 ISSN: 1042-3931 ISO Abbreviation: J Invasive Cardiol Publication Date: 2000 Oct |
Date Detail:
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Created Date: 2000-11-21 Completed Date: 2000-11-21 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8917477 Medline TA: J Invasive Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 497-501 Citation Subset: IM |
Affiliation:
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The Cardiac Catheterization Laboratory, Washington Hospital Center, 110 Irving Street, N.W., Suite 4B-1, Washington, DC 20010, USA. rxk3@mhg.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary* / adverse effects Antibodies, Monoclonal / therapeutic use* Cohort Studies Emergency Treatment / methods* Female Follow-Up Studies Humans Immunoglobulin Fab Fragments / therapeutic use* Male Middle Aged Myocardial Infarction / mortality*, therapy* Platelet Aggregation Inhibitors / therapeutic use* Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 143653-53-6/abciximab |
| Comments/Corrections | |
Comment In:
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J Invasive Cardiol. 2000 Oct;12(10):502-4
[PMID:
11022208
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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