| Reduction of major adverse cardiac events with intracoronary compared with intravenous bolus application of abciximab in patients with acute myocardial infarction or unstable angina undergoing coronary angioplasty. | |
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MedLine Citation:
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PMID: 12682003 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In patients with acute myocardial infarction or unstable angina undergoing coronary angioplasty, abciximab reduces major adverse cardiac events (MACE). Clinical trials have studied intravenous administration only. Intracoronary bolus application of abciximab causes very high local drug concentrations and may be more effective. We studied whether intracoronary bolus administration of abciximab is associated with a reduced MACE rate compared with the standard intravenous bolus application. METHODS AND RESULTS: We stratified 403 consecutive patients with acute myocardial infarction or unstable angina undergoing coronary angioplasty according to the type of application of abciximab. A 20-mg bolus of abciximab was given intravenously in 109 patients and intracoronarily in 294 patients. There were no differences between the groups with regard to diabetes mellitus, cardiogenic shock, successful intervention, or preprocedural and postprocedural TIMI flow. At 30 days, the incidence of MACE (death, myocardial infarction, urgent revascularization) was significantly lower in the patients with intracoronary compared with intravenous administration of abciximab (10.2% versus 20.2%; P<0.008), which was independent from stenting in multivariate analysis. The effect was most pronounced in patients with preprocedural TIMI 0/1 flow (MACE: intracoronary 11.8% versus intravenous 27.5%, P<0.002; n=273). CONCLUSIONS: In patients with acute myocardial infarction or unstable angina undergoing emergency coronary angioplasty, intracoronary bolus application of abciximab is associated with a reduction of MACE compared with the standard intravenous bolus application of abciximab. Prospective, randomized trials are warranted to further assess intracoronary application of abciximab. |
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Authors:
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Jochen Wöhrle; Olaf C Grebe; Thorsten Nusser; Eyas Al-Khayer; Stefan Schaible; Matthias Kochs; Vinzenz Hombach; Martin Höher |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article Date: 2003-04-07 |
Journal Detail:
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Title: Circulation Volume: 107 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2003 Apr |
Date Detail:
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Created Date: 2003-04-15 Completed Date: 2003-05-02 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: 1840-3 Citation Subset: AIM; IM |
Affiliation:
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Internal-Medicine-II, University of Ulm, Robert-Koch-Strasse-8, 89081 Ulm, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina, Unstable
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drug therapy,
mortality,
therapy* Angioplasty, Transluminal, Percutaneous Coronary / adverse effects* Antibodies, Monoclonal / administration & dosage*, therapeutic use Combined Modality Therapy Coronary Angiography Coronary Disease / epidemiology, etiology, prevention & control Female Heart Humans Immunoglobulin Fab Fragments / administration & dosage*, therapeutic use Incidence Infusions, Intravenous Male Middle Aged Myocardial Infarction / drug therapy, mortality, therapy* Recurrence / prevention & control Retrospective Studies |
| Chemical | |
Reg. No./Substance:
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0/Antibodies, Monoclonal; 0/Immunoglobulin Fab Fragments; 143653-53-6/abciximab |
| Comments/Corrections | |
Comment In:
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Circulation. 2003 Nov 11;108(19):e138; author reply e138
[PMID:
14610001
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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