Document Detail

Impact of early abciximab administration on infarct size in patients with ST-elevation myocardial infarction.
MedLine Citation:
PMID:  21035211     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Early abciximab administration in patients requiring transportation to undergo primary percutaneous coronary intervention (PPCI) has been reported to improve clinical outcome. We aimed to verify whether early administration leads to reduced infarct size (IS), assessed by delayed-enhancement magnetic resonance imaging (DE-MRI).
METHODS: We randomized 110 patients with acute myocardial infarction with symptom-to-diagnosis time <6h to either early (55 patients) or late (55 patients) abciximab administration. DE-MRI was performed at 4 days and 6 months. The primary end point was IS at 6 months. Secondary end points were the rate of ST-segment elevation resolution ≥ 50% (STR) at 60 min after PPCI, the extent of microvascular obstruction at 4 days, and the change in IS and transmurality at 6 months vs. 4 days.
RESULTS: DE-MRI was performed in 103 patients after 4 days, and in 87 at 6 months. The mean IS at 6 months was 13.8 ± 9.0% in the early vs. 13.0 ± 9.9% in the Late group (P>0.2). Similarly, microvascular obstruction and the change in IS were not significantly different. The Early group showed a significantly higher STR (94.5% vs. 80.0%, P=0.04) and a larger reduction in infarct transmurality (-9.2 ± 7.0% vs. -5.9 ± 6.4%; P=0.03), while a larger reduction in IS was observed only in patients with ECG-to-Cath Lab time >60 min.
CONCLUSIONS: Early abciximab administration did not lead to a smaller IS at 6-month DE-MRI, and was associated with a significant reduction in IS and transmurality only in patients with longer transportation time, warranting further investigation in this patient subset.
A Sonia Petronio; Marco De Carlo; Elisabetta Strata; Roberto Gistri; Cataldo Palmieri; Giovanni Aquaro; Gabriele Borelli; Marco Vaghetti; MariaGrazia Delle Donne; Massimo Lombardi; Sergio Berti
Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-10-28
Journal Detail:
Title:  International journal of cardiology     Volume:  155     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-08-10     Revised Date:  2013-05-24    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  230-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010. Published by Elsevier Ireland Ltd.
Cardiothoracic and Vascular Department, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.
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MeSH Terms
Angioplasty, Balloon, Coronary*
Antibodies, Monoclonal / administration & dosage*
Anticoagulants / administration & dosage*
Combined Modality Therapy
Drug Administration Schedule
Emergency Medical Services / methods*
Follow-Up Studies
Immunoglobulin Fab Fragments / administration & dosage*
Magnetic Resonance Imaging
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*,  mortality
Severity of Illness Index
Survival Rate
Time Factors
Reg. No./Substance:
0/Antibodies, Monoclonal; 0/Anticoagulants; 0/Immunoglobulin Fab Fragments; X85G7936GV/abciximab

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