Improved clinical outcomes with abciximab therapy in acute myocardial infarction: a systematic overview of randomized clinical trials - 26/08/11
, Vic Hasselblad, PhD a, James E Tcheng, MD a, Gregg W Stone, MD b, Robert M Califf, MD a, Adnan Kastrati, MD c, Franz-Josef Neumann, MD d, Sorin J Brener, MD e, Gilles Montalescot, MD, PhD f, David F Kong, MD a, Robert A Harrington, MD aAbstract |
Background |
Investigations of glycoprotein (GP) IIb/IIIa inhibition in primary percutaneous coronary intervention (PCI) have suggested the efficacy of abciximab in improving clinical and angiographic outcomes, but sample-size limitations and variability in trial design preclude the ability to generalize these results to a broader patient population.
Methods |
Meta-analytic techniques were used to evaluate clinical outcomes from randomized trials comparing GP IIb/IIIa inhibition with placebo or control therapy in primary PCI for acute myocardial infarction (MI).
Results |
In 3266 patients, treatment with abciximab significantly reduced the 30-day composite end point of death, reinfarction, or ischemic or urgent target-vessel revascularization (TVR; odds ratio [OR], 0.54; 95% CI, 0.40–0.72), with trends toward reduced 30-day death and death or reinfarction. Abciximab resulted in an increased likelihood of major bleeding (OR, 1.74; 95% CI, 1.11–2.72). By 6 months, abciximab significantly reduced the occurrence of death, reinfarction, or any TVR (OR, 0.80; 95% CI, 0.67–0.97), and there were positive trends favoring a decrease in mortality alone and the composite of death or reinfarction.
Conclusions |
Treatment with abciximab significantly reduces early adverse ischemic events, a clinical benefit that is maintained at 6-month follow-up. These findings support the use of adjunctive GP IIb/IIIa inhibition in primary PCI.
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 | Guest Editor for this manuscript was David A. Vorchheimer, MD, Mount Sinai Medical Center, New York, NY. |
Vol 147 - N° 3
P. 457-462 - mars 2004 Retour au numéro
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