| Intracoronary abciximab reduces death and major adverse cardiovascular events in acute coronary syndromes: A meta-analysis of clinical trials. | |
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MedLine Citation:
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PMID: 23273690 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Successful reperfusion of epicardial coronary arteries does not necessarily result in actual myocardial perfusion. Local intracoronary (IC) delivery of GP IIb/IIIa inhibitors (GPI) has been proposed to achieve further clinical efficacy when compared to standard intravenous (IV) administration. However clinical trials have shown conflicting results. The aim of the present study was to compare IC with IV abciximab administration on mortality and MACEs in patients with ACS undergoing PCI. METHODS: We performed a meta-analysis of all available clinical trials comparing intracoronary versus intravenous abciximab administration. RESULTS: At short-term analysis, incidence of MACEs was significantly lower in the IC group than in the IV group (OR=0.56; 95% CI 0.35-0.89; p=0.015). Interestingly, subgroup analysis showed that most benefit was coming from those studies with a main baseline LVEF<50% (OR=0.33 95% CI 0.18-0.59). Similarly, long-term incidence of MACEs was significantly lower in the IC group than in the IV group (OR=0.47; 95% CI 0.31-0.71; p<0.001), with most benefit coming from those studies enrolling patients with a main baseline EF<50% (OR=0.38 95% CI 0.23-0.63 p<0.001). In addition, long-term incidence of death was also lower in the IC group than in the IV group (OR=0.42; 95% CI 0.20-0.86; p=0.009). CONCLUSIONS: Our meta-analysis provides evidence of a net clinical benefit for intracoronary versus intravenous abciximab administration, with the highest benefit observed in high-risk ACS patients, such as those with reduced baseline LVEF. |
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Authors:
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Salvatore De Rosa; Gianluca Caiazzo; Daniele Torella; Ciro Indolfi |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-27 |
Journal Detail:
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Title: International journal of cardiology Volume: - ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-31 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Division of Cardiology, "Magna Graecia" University of Catanzaro, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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