Abciximab-facilitated percutaneous coronary intervention and long-term survival--a prospective single-center registry

Area of Science:

• Cardiology
• Interventional Cardiology
• Pharmacology

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Abciximab, a glycoprotein IIb/IIIa inhibitor, is used to reduce thrombotic complications during PCI.
• Predictors of abciximab use and its long-term impact on survival require further elucidation.

Purpose of the Study:

• To identify predictors of abciximab use in patients undergoing PCI.
• To evaluate the long-term (4-year) survival rates in patients treated with or without abciximab after PCI.
• To assess the impact of abciximab on procedural success and mortality across different patient subgroups.

Main Methods:

• Prospective registry evaluation of 10,471 patients undergoing PCI between 1995 and 2001.
• Propensity score analysis to identify independent predictors of abciximab use.
• Kaplan-Meier survival analysis and multivariate Cox proportional hazard modeling to assess 4-year mortality.
• Utilized the Social Security Death Index for survival data.

Main Results:

• Abciximab use was associated with higher procedural success (93% vs. 89%, P<0.001).
• Overall 4-year survival showed a trend towards improvement with abciximab (86.3% vs. 84.7%, P=0.09).
• In patients with acute coronary syndromes (ACS), abciximab was independently associated with improved 4-year survival (adjusted HR 0.87, P=0.05) and was strongly considered.
• Abciximab use increased rates of access site hematoma and blood product transfusion.

Conclusions:

• Abciximab significantly improves procedural success in PCI.
• Abciximab use is associated with reduced 4-year mortality, particularly in patients with acute coronary syndromes (ACS).
• Strong consideration of abciximab is warranted for ACS patients, while benefits are less pronounced in lower-risk populations.