TY - JOUR
T1 - Glycoprotein IIb-IIIa inhibition with abciximab and postprocedural risk assessment
T2 - Lessons from the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting trial and implication for ad hoc use of glycoprotein IIb-IIIa antagonists
AU - Mazur, Wojciech
AU - Kaluza, Grzegorz L.
AU - Sapp, Shelly
AU - Balog, Craig
AU - Topol, Eric J.
AU - Mark, Daniel B.
AU - Ellis, Stephen G.
AU - Kereiakes, Dean J.
AU - Lincoff, A. Michael
AU - Kleiman, Neal S.
N1 - Funding Information:
From the aBaylor College of Medicine and the Methodist Hospital; the bCleveland Clinic Foundation; cThe Lindner Center for Cardiovascular Research; and dDuke Clinical Research Organization. Supported with a grant from Centocor, Inc, Malvern, Pa, and from Eli Lilly and Co, Indianapolis, Ind. Submitted April 18, 2001; accepted November 5, 2001. Reprint requests: Neal S Kleiman, MD, 6535 Fannin, MS F-1090, Houston, TX 77030. E-mail: [email protected] Copyright 2002, Mosby, Inc. All rights reserved. 0002-8703/2002/$35.00 + 0 4/1/121519 doi:10.1067/mhj.2002.121519
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2002
Y1 - 2002
N2 - Background: Angiographic features of vessels in which stents have been deployed can be used to predict the risk of postprocedural ischemic events. The purpose of this study was to compare the effects of abciximab in patients with and without high-risk postprocedure features. Methods and Results: Protocol-mandated stent implantation was performed in 1586 patients in the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting trial, 783 of whom received abciximab, and was successful in 97% of the patients. High-risk features were defined as the presence of Thrombolysis In Myocardial Infarction (TIMI) flow <3, presence of thrombus or major dissection, or residual stenosis >10%. The primary endpoint was a composite of death, myocardial infarction, and urgent target vessel revascularization at 30 days. High-risk features were present in 21% of the patients. In patients without high-risk features after stent placement, abciximab reduced the primary endpoint from 9.0% to 3.9% (P <001) compared with 16.2% to 8.6% (P = .046) in patients in whom high-risk features were present. There was no statistical evidence of interaction between abciximab treatment and the presence or absence of high-risk features. Conclusion: Glycoprotein IIb-IIIa antagonism with abciximab is equally effective in prevention of a composite of ischemic events in patients with and without high-risk features after stent placement. However, patients in whom high-risk features are present after stent placement are at increased risk of ischemic cardiac events even with abciximab treatment.
AB - Background: Angiographic features of vessels in which stents have been deployed can be used to predict the risk of postprocedural ischemic events. The purpose of this study was to compare the effects of abciximab in patients with and without high-risk postprocedure features. Methods and Results: Protocol-mandated stent implantation was performed in 1586 patients in the Evaluation of Platelet IIb/IIIa Inhibitor for Stenting trial, 783 of whom received abciximab, and was successful in 97% of the patients. High-risk features were defined as the presence of Thrombolysis In Myocardial Infarction (TIMI) flow <3, presence of thrombus or major dissection, or residual stenosis >10%. The primary endpoint was a composite of death, myocardial infarction, and urgent target vessel revascularization at 30 days. High-risk features were present in 21% of the patients. In patients without high-risk features after stent placement, abciximab reduced the primary endpoint from 9.0% to 3.9% (P <001) compared with 16.2% to 8.6% (P = .046) in patients in whom high-risk features were present. There was no statistical evidence of interaction between abciximab treatment and the presence or absence of high-risk features. Conclusion: Glycoprotein IIb-IIIa antagonism with abciximab is equally effective in prevention of a composite of ischemic events in patients with and without high-risk features after stent placement. However, patients in whom high-risk features are present after stent placement are at increased risk of ischemic cardiac events even with abciximab treatment.
UR - http://www.scopus.com/inward/record.url?scp=0036241698&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036241698&partnerID=8YFLogxK
U2 - 10.1067/mhj.2002.121519
DO - 10.1067/mhj.2002.121519
M3 - Article
C2 - 11923795
AN - SCOPUS:0036241698
SN - 0002-8703
VL - 143
SP - 594
EP - 601
JO - American Heart Journal
JF - American Heart Journal
IS - 4
ER -