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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}


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

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  • 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