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Comparison of intracoronary vs. intravenous administration of abciximab in coronary stenting
Aman K Kakkar1, Ali Moustapha, Henry G Hanley
1Department of Medicine, Division of Cardiology, Louisiana State University Health Sciences Center, Shreveport, Louisiana 71130, USA.
Insights
Intracoronary abciximab administration showed better 6-month outcomes than intravenous for patients undergoing coronary stenting. This study suggests the intracoronary route may be superior for abciximab delivery, warranting further investigation.
Area of Science:
- Cardiology
- Pharmacology
- Interventional Cardiology
Background:
- Limited data exists comparing intracoronary (IC) versus intravenous (IV) abciximab beyond 30 days.
- Previous studies show good short-term outcomes for IC abciximab in animal and human trials.
Purpose of the Study:
- To compare the 6-month clinical outcomes of IC versus IV abciximab administration in patients undergoing coronary stenting.
Main Methods:
- Retrospective comparison of 101 patients receiving IC abciximab and 72 patients receiving IV abciximab.
- All patients received a standard dose of abciximab (0.25 mg/kg bolus) followed by a 12-hour infusion (0.125 microg/kg/min).
- Primary endpoint was the composite of death or myocardial infarction at 6 months.
Main Results:
- The 6-month composite endpoint of death or myocardial infarction was significantly lower in the IC group (5.9%) compared to the IV group (13.9%; P = 0.04).
- Bleeding complication rates were similar between the IC and IV administration groups.
Conclusions:
- Intracoronary administration of abciximab may be superior to intravenous administration for patients undergoing coronary stenting, showing improved 6-month clinical outcomes.
- Prospective randomized trials are needed to confirm these findings and validate the superiority of the IC route.
Abstract:
There have been animal and human studies looking at intracoronary (IC) use of abciximab with good short-term clinical outcomes. There exists no data comparing intracoronary with intravenous (IV) administration of abciximab beyond 30 days. We compared the clinical outcomes between the IC (n = 101) and IV (n = 72) group of patients. Patients who had coronary stenting and received abciximab were included in the study. All the patients received the standard systemic bolus dose of abciximab 0.25 mg/kg either via the IC or IV route, followed by a 12-hr IV infusion at 0.125 microg/kg/min. The 6-month composite endpoint of death or myocardial infarction was slightly higher in the IV (13.9%) than in the IC group (5.9%; P = 0.04). The frequency of bleeding complications was similar in both groups. The IC bolus route of abciximab may be superior to the intravenous route. Prospective randomized trials are warranted to validate these findings.
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