Document Detail


Clinical outcomes following "rescue" administration of abciximab in patients undergoing percutaneous coronary angioplasty.
MedLine Citation:
PMID:  11022207     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  12     ISSN:  1042-3931     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2000 Oct 
Date Detail:
Created Date:  2000-11-21     Completed Date:  2000-11-21     Revised Date:  2005-11-17    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  497-501     Citation Subset:  IM    
Affiliation:
The Cardiac Catheterization Laboratory, Washington Hospital Center, 110 Irving Street, N.W., Suite 4B-1, Washington, DC 20010, USA. rxk3@mhg.edu
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MeSH Terms
Descriptor/Qualifier:
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:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Platelet Aggregation Inhibitors; 143653-53-6/abciximab
Comments/Corrections
Comment In:
J Invasive Cardiol. 2000 Oct;12(10):502-4   [PMID:  11022208 ]

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


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