Intracoronary compared to intravenous abciximab in patients with st segment elevation myocardial infarction treated with primary percutaneous coronary intervention reduces mortality, target vessel revascularization and reinfarction after 1 year

Cardiology, 11/23/2011

In pPCI–treated ST segment elevation myocardial infarction (STEMI) patients treated with abciximab, intracoronary (IC) bolus administration resulted in a significant reduction in mortality, target vessel revascularization (TVR) and myocardial infarction (MI) compared to intravenous (IV) bolus administration.

Methods

  • A total of 355 pPCI–treated STEMI patients were randomized to either IC or IV bolus abciximab followed by a 12–hour IV infusion.
  • Patients were followed for 1 year to observe mortality, TVR or myocardial infarction (MI) and the combination of these.

Results

  • The two treatment arms (IV, n = 170; IC, n = 185) were similar with regard to baseline characteristics.
  • Mortality was reduced from 10% in the IV group to 2.7% in the IC group (p = 0.004).
  • TVR and MI were also reduced with IC administration (TVR: 14.1 vs. 7.6%, p = 0.04; MI: 11.8 vs. 5.4%, p = 0.03).
  • Consequently, patients in the IC treatment arm had a relative risk reduction of 55% for the combined endpoint after 1 year (p = 0.002) compared to the IV treatment arm.

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