Article Text

PDF
Beneficial effects of abciximab in patients with primary percutaneous intervention for acute ST segment elevation myocardial infarction in clinical practice
  1. T Heer1,
  2. U Zeymer1,
  3. C Juenger1,
  4. A K Gitt1,
  5. H Wienbergen1,
  6. R Zahn2,
  7. M Gottwik2,
  8. J Senges1,
  9. for the Acute Coronary Syndromes (ACOS) Registry Investigators
  1. 1Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany
  2. 2Department of Cardiology, Klinikum Nuernberg, Nuremberg, Germany
  1. Correspondence to:
    Dr Tobias Heer
    Herzzentrum Ludwigshafen, Department of Cardiology, Medizinische Klinik B, Bremserstrasse 79, D-67063 Ludwigshafen, Germany; heert{at}klilu.de

Abstract

Objectives: To assess the safety and effectiveness of abciximab in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) in clinical practice.

Methods: Data were analysed of 2184 consecutive patients treated with primary PCI for acute STEMI and either concomitant abciximab or no glycoprotein IIb/IIIa inhibitor (control group), who were prospectively enrolled in the Acute Coronary Syndromes (ACOS) registry between July 2000 and November 2002.

Results: Patients who were treated with abciximab were younger than the control group, and fewer of them had a history of stroke/transient ischaemic attack and systemic hypertension, but more of them had three-vessel coronary artery disease and cardiogenic shock. Cumulated mid-term survival for patients treated with abciximab was significantly higher than in the control group (91% v 79%, log rank p < 0.05, median observational time 375 days, range 12–34 months). The Cox proportional hazards model of mid-term mortality after admission with adjustment for baseline characteristics showed that mortality was significantly lower in the abciximab group than in the control group (hazard ratio 0.68, 95% confidence interval 0.49 to 0.95). Whereas overall there was no difference in bleeding complications, patients older than 75 years had more major bleeding events with abciximab (12.5% v 3.4%, p  =  0.03).

Conclusion: In clinical practice adjunctive treatment with abciximab in patients with primary PCI for acute STEMI was associated with a reduction in mid-term mortality. The subgroup of patients older than 75 years who were treated with abciximab had more major bleeding complications.

  • ACE, Abciximab and Carbostent Evaluation
  • ACEI, angiotensin-converting enzyme inhibitor
  • ACOS, Acute Coronary Syndromes
  • ADMIRAL, Abciximab Before Direct Angioplasty and Stenting in Myocardial Infarction Regarding Acute and Long-term Follow-up
  • CADILLAC, Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications
  • ISAR-2, Intracoronary Stenting and Antithrombotic Regimen-2
  • OR, odds ratio
  • PCI, percutaneous coronary intervention
  • RAPPORT, ReoPro and Primary PTCA Organization and Randomized Trial
  • STEMI, ST elevation myocardial infarction

Statistics from Altmetric.com

Footnotes

  • Published Online First 10 April 2006

  • Supported by a grant from MSD Sharp & Dohme, Haar, Germany, and from Lilly, Bad Homburg, Germany

  • The participants of ACOS registry are listed in Lorenz et al.14

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.