Mortality Reduction with Administration of Abciximab during Primary PCI is Confined to STEMI Patients with Complex Lesions
- *Corresponding Author:
- Allan Zeeberg Iversen
Department of Cardiology
Gentofte University Hospital
Niels Andersens Vej, Denmark
E-mail: [email protected]
Received date: January 14, 2013; Accepted date: January 24, 2013; Published date: February 01, 2013
Citation: Iversen AZ, Galatius S, Pedersen S, Abildgaard U, Jensen JS (2013) Mortality Reduction with Administration of Abciximab during Primary PCI is Confined to STEMI Patients with Complex Lesions. Cardiol Pharmacol 2:103. doi: 10.4172/2329-6607.1000103
Copyright: © 2013 Iversen AZ, 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 th original author and source are credited.
Aim: The optimal timing of abciximab administration (´up-stream´/´in-cath-lab´) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) is unclear. Data suggest that patients with high-risk profiles benefit from abciximab the most. Complex lesion on coronary angiography (CAG) implies a high-risk profile. Thus, we aimed to investigate whether lesion type (complex/simple) predicted the effect of abciximab in STEMI-patients undergoing pPCI.
Methods and results: 2,935 STEMI-patients treated with pPCI were retrospectively stratified according
to lesion type on CAG (complex/simple) and use of abciximab. Endpoints at 1 year were mortality, target vessel revascularization (TVR), myocardial infarction (MI), and the combination of these. Forty-seven percent had complex lesion on CAG. Among those, abciximab reduced one year mortality in both the univariate (from 12.7% to 7.8%, p=0.006) and the adjusted analysis (HR 0.62, CI 0.42-0.91, p=0.015). Patients with simple lesions had no mortality benefit of abciximab. Effect of abciximab on TVR or MI was neutral. Regarding the combined endpoint, abciximab treatment conferred a risk reduction in patients with complex lesions.
Conclusion: Benefit of abciximab in STEMI-patients undergoing pPCI was confined to those with complex lesions on CAG. Consequently, early abciximab treatment without knowledge of the lesion type may not be recommended