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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Abciximab in patients with acute ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary

Julinda Mehilli1, Adnan Kastrati, Stefanie Schulz

  • 1Deutsches Herzzentrum, Technische Universität, Munich, Germany. mehilli@dhm.mhn.de

Circulation
|April 1, 2009
PubMed

Insights

Adding abciximab to clopidogrel did not reduce infarct size in ST-segment-elevation myocardial infarction patients. This study found no significant benefit in major adverse events or bleeding complications with abciximab use.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Pharmacology

Background:

  • Abciximab, a glycoprotein IIb/IIIa receptor inhibitor, enhances primary percutaneous coronary interventions for acute myocardial infarction.
  • The benefit of abciximab after clopidogrel loading in ST-segment-elevation myocardial infarction (STEMI) remains unclear.

Purpose of the Study:

  • To determine if abciximab improves outcomes in STEMI patients already treated with clopidogrel.
  • To assess the impact of abciximab on infarct size and major adverse cardiac events.

Main Methods:

  • 800 STEMI patients within 24 hours of symptom onset, all on 600 mg clopidogrel, were randomized to abciximab or placebo.
  • Infarct size was measured by SPECT using technetium-99m sestamibi before discharge.
  • A composite of death, recurrent MI, stroke, or urgent revascularization was tracked at 30 days.

Main Results:

  • Mean infarct size was 15.7% in the abciximab group versus 16.6% in the placebo group (P=0.47).
  • The composite endpoint occurred in 5.0% of the abciximab group and 3.8% of the placebo group (P=0.40).
  • Major bleeding complications occurred in 1.8% of patients in both groups.

Conclusions:

  • Upstream abciximab administration does not reduce infarct size in STEMI patients receiving 600 mg clopidogrel.
  • Abciximab did not show a significant benefit in reducing major adverse events or increasing bleeding risk in this patient population.
Abstract

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