alexa Lack of Peri-Procedural Myocardial Necrosis Reduction f
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
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Research Article

Lack of Peri-Procedural Myocardial Necrosis Reduction from Abciximab in Patients on Dual Antiplatelet Therapy Revascularized with Rotational Atherectomy

Juan García-Lara*, Eduardo Pinar-Bermúdez, Javier Lacunza-Ruiz, Raúl Valdesuso-Aguilar, José A Hurtado, Juan R Gimeno and Mariano Valdés-Chávarri
Servicio de Cardiología, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
Corresponding Author : Juan García-Lara, MD
Servicio de Cardiología
Hospital Universitario Virgen de la Arrixaca
Murcia 30120, Spain
Tel: +34 968 369 893
Fax: +34 968 369 893
E-mail: [email protected]
Received: August 20, 2013; Accepted: September 10, 2013; Published: September 13, 2013
Citation: García-Lara J, Pinar-Bermúdez E, Lacunza-Ruiz J, Valdesuso-Aguilar R, Hurtado JA, et al. (2013) Lack of Peri-Procedural Myocardial Necrosis Reduction from Abciximab in Patients on Dual Antiplatelet Therapy Revascularized with Rotational Atherectomy. J Clin Exp Cardiolog 4:270. doi:10.4172/2155-9880.1000270
Copyright: © 2013 García-Lara J, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Rotational atherectomy allows plaque remodeling in severely calcified lesions and, prior to the adoption of clopidogrel as standard therapy, small trials showed that abciximab reduces transient hypoperfusion associated with the procedure. However, no studies have evaluated it among patients receiving dual antiplatelet therapy. This study aimed to evaluate whether abciximab reduces procedure-related myocardial injury in a non-selected population of patients receiving dual antiplatelet therapy. The study comprised a retrospective review of a nonselected cohort of 139 consecutive procedures of rotational atherectomy performed in patients pre-treated with dual antiplatelet therapy. Abciximab was administered in 48 (34.5%) patients, whereas 91 (65.5%) did not receive it. The only difference between groups was a higher rate of diabetes mellitus in the abciximab group (89% vs. 51%, p=0.001). The rate of procedural complications was 10.5% for patients with abciximab vs. 6.2% for patients without (p=0.537). After 24 hours, the peak of biomarkers of myocardial damage (CKmb and TnT) did not differ, and the rate of procedure-related myocardial injury was 23.9% with abciximab and 20.7% without (p=0.664). In a restricted analysis to diabetic patients (n=84), the rate of myocardial injury was 27.5% with abciximab vs. 18.6% without, (p=0.435). After adjusting by clinical and procedural parameters in a logistic regression model, abciximab use did not confer any significant reduction on procedure-related myocardial injury. In conclusion, in a non-selected cohort of patients receiving dual antiplatelet therapy, the administration of abciximab in the setting of rotational atherectomy did not reduce the incidence of procedure related myocardial injury.

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