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The influence of abciximab use on clinical outcome after aortocoronary vein graft interventions
V Mathew1, D E Grill, C G Scott
1Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. mathew.verghese@mayo.edu
Insights
Abciximab use did not improve outcomes in patients undergoing aortocoronary vein graft interventions, even in high-risk cases. This finding contrasts with its known benefits in other percutaneous coronary interventions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Abciximab is proven beneficial in percutaneous coronary interventions.
- Limited data exists on abciximab's efficacy in vein graft interventions.
Purpose of the Study:
- To evaluate the impact of abciximab on clinical outcomes in aortocoronary vein graft interventions.
Main Methods:
- A retrospective study of 343 patients undergoing vein graft interventions.
- Comparison of outcomes between 210 patients without abciximab and 133 patients with abciximab.
Main Results:
- Baseline characteristics differed, with higher risk factors in both groups.
- Similar angiographic and procedural success rates were observed with or without abciximab.
- Abciximab did not influence in-hospital or long-term composite endpoints (death/myocardial infarction/repeat revascularization) after adjusting for baseline differences.
Conclusions:
- Periprocedural abciximab administration does not appear to reduce major adverse clinical events in high-risk patients undergoing aortocoronary vein graft interventions.
Objectives:
The purpose of this study was to evaluate the effect of abciximab use on clinical outcome in aortocoronary vein graft interventions.
Background:
Although large randomized trials have demonstrated a significant benefit of abciximab use in the setting of percutaneous coronary interventions, there is relatively little data with respect to the use of this agent in percutaneous vein graft interventions.
Methods:
Three hundred and forty-three patients were identified; 210 undergoing vein graft intervention without abciximab and 133 patients with abciximab.
Results:
There were differences in baseline clinical and angiographic characteristics between the two groups; advanced age, unstable angina, older vein grafts and thrombus containing lesions were relatively common in both groups. Angiographic and procedural success rates were similar with or without the use of abciximab (89% vs. 92%, p = 0.15, and 85% vs. 91%, p = 0.12, respectively). The in-hospital composite end point of death/Q-wave myocardial infarction (QWMI)/repeat revascularization was similar between the two groups. Utilizing statistical modeling to adjust for baseline differences between the groups, abciximab use did not influence the cumulative long-term composite end point of death/MI/repeat revascularization.
Conclusions:
This study demonstrates that in this relatively high-risk population undergoing aortocoronary vein graft interventions, the administration of abciximab periprocedurally does not appear to reduce major adverse clinical events.
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