Document Detail


Effect of abciximab on angiographic complications during percutaneous coronary stenting in the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT).
MedLine Citation:
PMID:  12398954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the Evaluation of Platelet IIb/IIIa Inhibition in Stenting Trial (EPISTENT), abciximab reduced ischemic complications of stent implantation at 30 days and 6 months. The responsible mechanisms remain unclear. We sought to determine if abciximab decreases ischemic complications by decreasing the incidence of angiographic complications during coronary stenting. In EPISTENT, patients were randomized to stenting with abciximab (abciximab group), stenting with placebo (placebo group), or balloon angioplasty with abciximab. Angiographic complications (including major or minor dissection, distal embolization, thrombus postprocedure, side branch or other vessel occlusion, residual stenosis >50%, transient coronary occlusion, and Thrombolysis In Myocardial Infarction final flow <3) were recorded prospectively. Creatine kinase (CK)-MB enzyme levels after intervention were measured at 6-hour intervals. We analyzed angiographic complications and CK-MB elevations in the abciximab group (n = 784) and the placebo group (n = 803). Angiographic complications were 29% less frequent in the abciximab group compared with the placebo group (17.0% vs 23.8%; p = 0.001). In patients with angiographic complications, there was a nonsignificant reduction in the incidence of CK-MB elevation >3 times normal with abciximab therapy (19.7% vs 24.5% in placebo group; p = 0.314). Abciximab (compared with placebo) significantly reduced the incidence of CK-MB elevation >3 times normal in those without any angiographic complications (6.5% vs 10.7%; p = 0.007). In summary, abciximab (compared with placebo) significantly reduced angiographic complications during coronary stenting. Abciximab also prevented CK-MB elevations in patients without angiographic complications.
Authors:
M Ashequl Islam; James C Blankenship; Craig Balog; Elias A Iliadis; A Michael Lincoff; James E Tcheng; Robert M Califf; Eric J Topol;
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Publication Detail:
Type:  Clinical Trial; Clinical Trial, Phase III; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  90     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Nov 
Date Detail:
Created Date:  2002-10-25     Completed Date:  2002-12-09     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  916-21     Citation Subset:  AIM; IM    
Affiliation:
Geisinger Medical Center, Danville, Pennsylvania 17822, USA.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / therapeutic use*
Blood Vessel Prosthesis Implantation
Coronary Angiography / adverse effects*
Creatine Kinase / blood,  drug effects
Creatine Kinase, MB Form
Double-Blind Method
Drug Evaluation
Endpoint Determination
Female
Humans
Immunoglobulin Fab Fragments / therapeutic use*
Incidence
Isoenzymes / blood,  drug effects
Male
Myocardial Ischemia / epidemiology,  etiology,  therapy
North America / epidemiology
Platelet Aggregation Inhibitors / therapeutic use*
Platelet Glycoprotein GPIIb-IIIa Complex / therapeutic use*
Stents*
Survival Analysis
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 0/Isoenzymes; 0/Platelet Aggregation Inhibitors; 0/Platelet Glycoprotein GPIIb-IIIa Complex; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form; X85G7936GV/abciximab

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


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