Effect of glycoprotein IIb/IIIa receptor blockade with abciximab on clinical and angiographic restenosis rate after the placement of coronary stents following acute myocardial infarction

Abstract

In patients undergoing stenting following AMI, abciximab exerted beneficial effects by substantially reducing the 30-day rate of major adverse cardiac events. During one-year follow-up, there was no additional benefit from a reduction in TLR nor did abciximab reduce angiographic restenosis.

Abciximab-Supported Infarct Artery Stent Implantation for Acute Myocardial Infarction and Long-Term Survival

“…[3][4][5]9 However, all studies showed that the benefit is mainly due to the decrease in post-PCI early coronary complications such as myocardial infarction or the need for urgent target vessel revascularization, and no individual study could demonstrate a decrease in mortality rates. A recent meta-analysis of 4 PCI-AMI trials shows that abciximab therapy results in a significant decrease in the need for urgent target vessel revascularization but not in reductions of death or recurrent myocardial infarction.…”

“…1,2 However, previous concluded randomized trials comparing abciximab with placebo in patients undergoing infarct artery stenting for acute myocardial infarction (AMI) have produced conflicting results, and no individual trial detected a significant mortality benefit. [3][4][5] The ACE (Abciximab and Carbostent Evaluation) Trial demonstrated a strong benefit of abciximab as adjunctive treatment to infarct artery stenting for AMI at 1-and 6-month followup, with a lower rate of the composite of death and reinfarction at 6 months (5.5% versus 13.5%, Pϭ0.006). 6 This effect was related in part to the already-established protective effect against early target vessel failure and in part to better myocardial reperfusion, as shown by the more frequent early ST-segment resolution and smaller infarcts in abciximabtreated patients as compared with placebo.…”

Efficacy and Safety of Unfractionated Heparin Plus Glycoprotein IIb/IIIa Inhibitors During Revascularization for an Acute Coronary Syndrome: A Meta‐Analysis of Randomized Trials Performed With Stents and Thienopyridines

“…Stroke data were available for 5 studies and was not significantly different between GPIs and control (RR = 0.37; 95% CI, 0.13-1.08; P = 0.068). 6,15,17,25,28,30 All-Cause Mortality The incidence of mortality at 30 days was 2.2% with GPIs versus 2.9% with control (RR = 0.79; 95% CI, 0.59-1.06; P = 0.12) (Figure 4). Publication bias was not detected (Begg's test P = 0.72, Egger's test P = 0.97) and heterogeneity was not observed (I 2 = 0%).…”

Pharmacoinvasive Therapy

“…[43][44][45][46] (2) GP IIb/IIIa inhibitors are helpful for reducing recurrent MI and urgent target vessel revascularization; the evidence for their ability to contribute to a reduction in mortality rates is less clear. [47][48][49][50][51] Abciximab is the best-studied of the GP IIb/IIIa inhibitors; only limited angiographic data are available on the small molecule inhibitors. 52 It appears helpful to administer abciximab before arrival in the catheterization laboratory so that platelet inhibition has been initiated before coronary instrumentation.…”