Use of abciximab prevents microcirculatory impairment in patients treated with coronary angioplasty for unstable angina: Results of a prospective randomized study

Abstract

The use of abciximab during percutaneous coronary angioplasty (PTCA) in patients with unstable angina (UA) prevents the postintervention enzyme surge and improves clinical outcomes, possibly by improving microcirculatory function. The aim of this quantitative myocardial blush grade (MBG) study was to verify whether abciximab improves postintervention microcirculation in patients with UA. This prospective randomized open-label study involved 140 UA patients scheduled to undergo PTCA of the target coronary lesion: 140 patients were randomized to receive either abciximab during PTCA (group 1, 70 patients) or conventional treatment without GP IIb/IIIa inhibitor (group 2, 70 patients). The exclusion criteria included above normal CK-MB levels. MBG was calculated by means of quantitative software that evaluates video intensity in a given region of interest: assuming that greater peak video intensity reflects a larger myocardial blood volume, a perfusion scale of 1-6 points (poor to optimal) was devised. The groups were homogeneous in terms of their demographic, procedural, and angiographic characteristics. Stents were used in 98% of the patients in both groups. The MBG score significantly increased in group 1 from 3.04 +/- 2.17 to 3.71 +/- 2.02 (P = 0.045) and slightly decreased in group 2 from 3.13 +/- 2.07 to 2.93 +/- 2.03 (P = 0.42). Consequently, group 1 showed a significantly greater postintervention MBG score (3.71 +/- 2.02 vs. 2.93 +/- 2.03; P = 0.022) and had a significantly greater MBG score change (P = 0.025). The results of this randomized study show that the administration of abciximab prevents microcirculatory impairment in patients undergoing angioplasty for acute coronary syndromes.

Turbulence monitoring with Doppler Optical Coherence Tomography

“…In the current Letters we present the results of monitoring of turbulent flow in T-and Y-shaped micro vessel junctions with DOCT, a logical extension of an earlier study [3]. The results of this study are highly important in rheology and cardiology to better understand the effect of blood flow on the rupture potential of atherosclerotic plaques [4].…”

Intracoronary Administration of Abciximab During Percutaneous Coronary Interventions: Should This Be the Routine and Preferred Approach?

“…Abciximab prevents distal platelet microembolization after PCI 20 and preserves microvascular function and perfusion after PCI 21,22 and combined thrombolytic/abciximab therapy. 23 Abciximab dissolves platelet-rich thrombi by displacing fibrinogen from the platelet glycoprotein IIb/IIIa receptor.…”

Efficacy and Safety of Glycoprotein IIb/IIIa Inhibitors During Elective Coronary Revascularization

“…Safety. Major bleeding was reported in all but 7 trials (27)(28)(29)(30)(32)(33)(34). The incidence of major bleeding was 1.2% with GPI versus 0.9% with control (RR: 1.37, 95% CI: 0.83 to 2.25, p ϭ 0.22) (Fig.…”

“…Our search identified 22 studies with 10,123 patients (Fig. 1, Table 1) (10,11,(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40). The studies examined a variety of clinical outcomes, including 7 that used a nonclinical primary outcome (Table 2) (23,24,26,27,30,32,34).…”